Initial Management of Acute Pancreatitis
Publication Date: March 1, 2018
Last Updated: December 16, 2022
Treatment
Summary of Recommendations of the AGA Clinical Guideline for the Initial Management of Acute Pancreatitis
In patients with acute pancreatitis, AGA suggests using goal-directed therapy for fluid management. ( Very Low , Conditional (weak) )
Comment: AGA makes no recommendation whether normal saline or ringer’s lactate is used.
612
In patients with acute pancreatitis, AGA suggests against the use of hydroxyethyl starch (HES) fluids. ( Very Low , Conditional (weak) )
612
In patients with predicted severe acute pancreatitis and necrotizing pancreatitis, AGA suggests against the use of prophylactic antibiotics. ( Low , Conditional (weak) )
612
In patients with acute biliary pancreatitis and no cholangitis, AGA suggests against the routine use of urgent ERCP. ( Low , Conditional (weak) )
612
In patients with acute pancreatitis, AGA recommends early (within 24 hours) oral feeding as tolerated rather than keeping the patient NPO. ( Moderate , Strong )
612
In patients with acute pancreatitis and inability to feed orally, AGA recommends enteral rather than parenteral nutrition. ( Moderate , Strong )
612
In patients with predicted severe or necrotizing pancreatitis requiring enteral tube feeding, AGA suggests either nasogastric or nasoenteral route. ( Low , Conditional (weak) )
612
In patients with acute biliary pancreatitis, AGA recommends cholecystectomy during the initial admission rather than following discharge. ( Moderate , Strong )
612
In patients with acute alcoholic pancreatitis, AGA recommends brief alcohol intervention during admission. ( Moderate , Strong )
612
Recommendation Grading
Overview
Title
Initial Management of Acute Pancreatitis
Authoring Organization
American Gastroenterological Association
Publication Month/Year
March 1, 2018
Last Updated Month/Year
March 12, 2024
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Target Patient Population
Patients with acute pancreatitis
Inclusion Criteria
Male, Female, Adolescent, Adult, Older adult
Health Care Settings
Ambulatory, Emergency care, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Treatment, Management
Diseases/Conditions (MeSH)
D010195 - Pancreatitis, D019283 - Pancreatitis, Acute Necrotizing, D000081032 - Pancreatitis, Acute Hemorrhagic
Keywords
acute pancreatitis, pancreatitis, ERCP