Article of interest: Initial management of acute pancreatitis

Chaitoff A, Cifu AS, Niforatos JD. Initial Management of Acute Pancreatitis. JAMA. 2020 May 7. doi: 10.1001/jama.2020.2177. [Epub ahead of print]

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Major recommendations:

  • In patients with acute pancreatitis, early oral feeding as tolerated (within 24 hours) is recommended (strong recommendation; moderate evidence).
  • If patients are unable to tolerate oral feeding, enteral (oral or enteral tube) rather than parenteral nutrition is recommended (strong recommendation; moderate evidence).
  • In patients with acute biliary pancreatitis, cholecystectomy should be performed during the initial admission rather than after discharge (strong recommendation; moderate evidence).
  • In patients with acute alcoholic pancreatitis, a brief alcohol intervention should be performed during the initial admission (strong recommendation; moderate evidence).
  • In patients with predicted severe acute pancreatitis and necrotizing acute pancreatitis, the guidelines suggest against use of prophylactic antibiotics (conditional recommendation; low evidence).