Assessment of the treatment of acute pancreatitis

Background: The first international evidence-based guidelines for the management of acute pancreatitis were published in 1998. The aim of this study was to compare the care giving to patients with these guidelines.

Methods: During the period, June 1996 to May 1999, a survey was carried out of all patients with acute pancreatitis six months after discharge.

Results: One hundred and fifty-five patients with a first attack were identified within 48 hours (goal: 100%). Fifty (32%) had gallstones identified. Fifty-one (32%) were severe cases with ten (20%) deaths (goal: < 30%). The overall mortality (6.4%) was within the goal of less than 10%. Objective severity stratification (Ranson scoring) was performed in 94% (goal: 100%), and in severe cases 82% (goal: 100%) had a CT. In severe gallstone pancreatitis, 90% (goal: 100%) underwent an early ERCP (< 72 hours after admission). One management goal was not met: in mild cases, only 20-25% (goal: 100%) with gallstone pancreatitis were given definitive treatment within four weeks.

Conclusions: The treatment we offer our patients with acute pancreatitis is optimal--apart from one standard--when compared with international guidelines, but in spite of this exception the mortality rate is low.