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Published in: Current Gastroenterology Reports 2/2010

01-04-2010

Update in Acute Pancreatitis

Authors: Bechien U. Wu, Darwin L. Conwell

Published in: Current Gastroenterology Reports | Issue 2/2010

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Abstract

Acute pancreatitis is a common cause for hospitalization that carries a substantial burden of disease in the United States and worldwide. Recent reports have encompassed a wide array of topics including new insights into the acinar cell pH microenvironment, signal pathways for acinar cell fate, and the innate immune response. Clinical researchers have reported new methods to assess disease severity, innovative techniques for management of local complications, the importance of early recognition of pancreatic or extrapancreatic infection, and prevention of disease recurrence. Recent data also suggest that specialized centers may be of benefit for the management of severe acute pancreatitis. This review summarizes a number of recent advances in basic and clinical science with an emphasis on findings that are relevant to clinicians who manage patients with acute pancreatitis.
Literature
1.
go back to reference • Everhart JE, Ruhl CE: Burden of digestive diseases in the United States part III: liver, biliary tract, and pancreas. Gastroenterology 2009, 136:1134–1144. This article provides an update on the etiology of pancreatitis in the United States using several national health surveys. • Everhart JE, Ruhl CE: Burden of digestive diseases in the United States part III: liver, biliary tract, and pancreas. Gastroenterology 2009, 136:1134–1144. This article provides an update on the etiology of pancreatitis in the United States using several national health surveys.
2.
go back to reference Fagenholz PJ, Castillo CF, Harris NS, et al.: Increasing United States hospital admissions for acute pancreatitis, 1988–2003. Ann Epidemiol 2007, 17:491–497.CrossRefPubMed Fagenholz PJ, Castillo CF, Harris NS, et al.: Increasing United States hospital admissions for acute pancreatitis, 1988–2003. Ann Epidemiol 2007, 17:491–497.CrossRefPubMed
3.
go back to reference Fagenholz PJ, Fernandez-del Castillo C, Harris NS, et al.: Direct medical costs of acute pancreatitis hospitalizations in the United States. Pancreas 2007, 35:302–307. Fagenholz PJ, Fernandez-del Castillo C, Harris NS, et al.: Direct medical costs of acute pancreatitis hospitalizations in the United States. Pancreas 2007, 35:302–307.
4.
go back to reference •• Bhoomagoud M, Jung T, Atladottir J, et al.: Reducing extracellular pH sensitizes the acinar cell to secretagogue-induced pancreatitis responses in rats. Gastroenterology 2009, 137:1083–1092. This study presents a compelling series of in vitro and in vivo experiments in caereulin-induced pancreatitis models that indicate the importance of extracellular pH on sensitization of acinar cells. •• Bhoomagoud M, Jung T, Atladottir J, et al.: Reducing extracellular pH sensitizes the acinar cell to secretagogue-induced pancreatitis responses in rats. Gastroenterology 2009, 137:1083–1092. This study presents a compelling series of in vitro and in vivo experiments in caereulin-induced pancreatitis models that indicate the importance of extracellular pH on sensitization of acinar cells.
5.
go back to reference Noble MD, Romac J, Vigna SR, Liddle RA: A pH-sensitive, neurogenic pathway mediates disease severity in a model of post-ERCP pancreatitis. Gut 2008, 57:1566–1571.CrossRefPubMed Noble MD, Romac J, Vigna SR, Liddle RA: A pH-sensitive, neurogenic pathway mediates disease severity in a model of post-ERCP pancreatitis. Gut 2008, 57:1566–1571.CrossRefPubMed
6.
go back to reference • He S, Wang L, Miao L, et al: Receptor interacting protein kinase-3 determines cellular necrotic response to TNF-alpha. Cell 2009, 137:1100–1111. This study presents a compelling series of experiments that demonstrate the central role of RIP3 kinase in mediating necrosis as a pathway for cell death. • He S, Wang L, Miao L, et al: Receptor interacting protein kinase-3 determines cellular necrotic response to TNF-alpha. Cell 2009, 137:1100–1111. This study presents a compelling series of experiments that demonstrate the central role of RIP3 kinase in mediating necrosis as a pathway for cell death.
7.
go back to reference Zhang DW, Shao J, Lin J, et al.: RIP3, an energy metabolism regulator that switches TNF-induced cell death from apoptosis to necrosis. Science 2009, 325:332–336.CrossRefPubMed Zhang DW, Shao J, Lin J, et al.: RIP3, an energy metabolism regulator that switches TNF-induced cell death from apoptosis to necrosis. Science 2009, 325:332–336.CrossRefPubMed
8.
go back to reference Sharif R, Dawra R, Wasiluk K, et al.: Impact of toll-like receptor 4 on the severity of acute pancreatitis and pancreatitis-associated lung injury in mice. Gut 2009, 58:813–819.CrossRefPubMed Sharif R, Dawra R, Wasiluk K, et al.: Impact of toll-like receptor 4 on the severity of acute pancreatitis and pancreatitis-associated lung injury in mice. Gut 2009, 58:813–819.CrossRefPubMed
9.
go back to reference Harrison DA, D’Amico G, Singer M: The Pancreatitis Outcome Prediction (POP) Score: a new prognostic index for patients with severe acute pancreatitis. Crit Care Med 2007, 35:1703–1708.CrossRefPubMed Harrison DA, D’Amico G, Singer M: The Pancreatitis Outcome Prediction (POP) Score: a new prognostic index for patients with severe acute pancreatitis. Crit Care Med 2007, 35:1703–1708.CrossRefPubMed
10.
go back to reference Banks PA, Freeman ML: Practice guidelines in acute pancreatitis. Am J Gastroenterol 2006, 101:2379–2400.CrossRefPubMed Banks PA, Freeman ML: Practice guidelines in acute pancreatitis. Am J Gastroenterol 2006, 101:2379–2400.CrossRefPubMed
11.
go back to reference Forsmark CE, Baillie J: AGA Institute technical review on acute pancreatitis. Gastroenterology 2007, 132:2022–2044.CrossRefPubMed Forsmark CE, Baillie J: AGA Institute technical review on acute pancreatitis. Gastroenterology 2007, 132:2022–2044.CrossRefPubMed
12.
go back to reference Wu BU, Johannes RS, Sun X, et al.: The early prediction of mortality in acute pancreatitis: a large population-based study. Gut 2008, 57:1698–1703.CrossRefPubMed Wu BU, Johannes RS, Sun X, et al.: The early prediction of mortality in acute pancreatitis: a large population-based study. Gut 2008, 57:1698–1703.CrossRefPubMed
13.
go back to reference Singh VK, Wu BU, Bollen TL, et al.: A prospective evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancreatitis. Am J Gastroenterol 2009, 104:966–971.CrossRefPubMed Singh VK, Wu BU, Bollen TL, et al.: A prospective evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancreatitis. Am J Gastroenterol 2009, 104:966–971.CrossRefPubMed
14.
go back to reference •• Wu BU, Johannes RS, Sun X, et al.: Early changes in blood urea nitrogen predict mortality in acute pancreatitis. Gastroenterology 2009, 137:129–135. This large, retrospective cohort study identified an early rise (first 24 hours) in BUN as the most accurate routine laboratory test for identification of patients at increased risk of mortality from acute pancreatiits. •• Wu BU, Johannes RS, Sun X, et al.: Early changes in blood urea nitrogen predict mortality in acute pancreatitis. Gastroenterology 2009, 137:129–135. This large, retrospective cohort study identified an early rise (first 24 hours) in BUN as the most accurate routine laboratory test for identification of patients at increased risk of mortality from acute pancreatiits.
15.
go back to reference Wu BU, Johannes RS, Conwell DL, Banks PA: Early hemoconcentration predicts increased mortality only among transferred patients with acute pancreatitis. Pancreatology 2009, 9:639–643.CrossRefPubMed Wu BU, Johannes RS, Conwell DL, Banks PA: Early hemoconcentration predicts increased mortality only among transferred patients with acute pancreatitis. Pancreatology 2009, 9:639–643.CrossRefPubMed
16.
go back to reference Lankisch PG, Weber-Dany B, Hebel K, et al.: The harmless acute pancreatitis score: a clinical algorithm for rapid initial stratification of nonsevere disease. Clin Gastroenterol Hepatol 2009, 7:702–705; quiz 607. Lankisch PG, Weber-Dany B, Hebel K, et al.: The harmless acute pancreatitis score: a clinical algorithm for rapid initial stratification of nonsevere disease. Clin Gastroenterol Hepatol 2009, 7:702–705; quiz 607.
17.
go back to reference •• Dellinger EP, Tellado JM, Soto NE, et al: Early antibiotic treatment for severe acute necrotizing pancreatitis: a randomized, double-blind, placebo-controlled study. Ann Surg 2007, 245:674–683. This double-blind, randomized, controlled trial demonstrated no reduction in infectious complications or mortality associated with use of prophlactic antibiotics for severe acute pancreatitis. •• Dellinger EP, Tellado JM, Soto NE, et al: Early antibiotic treatment for severe acute necrotizing pancreatitis: a randomized, double-blind, placebo-controlled study. Ann Surg 2007, 245:674–683. This double-blind, randomized, controlled trial demonstrated no reduction in infectious complications or mortality associated with use of prophlactic antibiotics for severe acute pancreatitis.
18.
go back to reference Isenmann R, Runzi M, Kron M, et al.: Prophylactic antibiotic treatment in patients with predicted severe acute pancreatitis: a placebo-controlled, double-blind trial. Gastroenterology 2004, 126:997–1004.CrossRefPubMed Isenmann R, Runzi M, Kron M, et al.: Prophylactic antibiotic treatment in patients with predicted severe acute pancreatitis: a placebo-controlled, double-blind trial. Gastroenterology 2004, 126:997–1004.CrossRefPubMed
19.
go back to reference • Besselink MG, van Santvoort HC, Boermeester MA, et al.: Timing and impact of infections in acute pancreatitis. Br J Surg 2009, 96:267–273. This large cohort study presents rich and detailed information on the incidence and impact of both intra- and extrapancreatic infection in acute pancreatitis. • Besselink MG, van Santvoort HC, Boermeester MA, et al.: Timing and impact of infections in acute pancreatitis. Br J Surg 2009, 96:267–273. This large cohort study presents rich and detailed information on the incidence and impact of both intra- and extrapancreatic infection in acute pancreatitis.
20.
go back to reference Wu BU, Johannes RS, Kurtz S, Banks PA: The impact of hospital-acquired infection on outcome in acute pancreatitis. Gastroenterology 2008, 135:816–820.CrossRefPubMed Wu BU, Johannes RS, Kurtz S, Banks PA: The impact of hospital-acquired infection on outcome in acute pancreatitis. Gastroenterology 2008, 135:816–820.CrossRefPubMed
21.
go back to reference Vege SS, Gardner TB, Chari ST, et al.: Outcomes of intra-abdominal fungal vs. bacterial infections in severe acute pancreatitis. Am J Gastroenterol 2009, 104:2065–2070.CrossRefPubMed Vege SS, Gardner TB, Chari ST, et al.: Outcomes of intra-abdominal fungal vs. bacterial infections in severe acute pancreatitis. Am J Gastroenterol 2009, 104:2065–2070.CrossRefPubMed
22.
go back to reference Mortele KJ, Girshman J, Szejnfeld D, et al.: CT-guided percutaneous catheter drainage of acute necrotizing pancreatitis: clinical experience and observations in patients with sterile and infected necrosis. AJR Am J Roentgenol 2009, 192:110–116.CrossRefPubMed Mortele KJ, Girshman J, Szejnfeld D, et al.: CT-guided percutaneous catheter drainage of acute necrotizing pancreatitis: clinical experience and observations in patients with sterile and infected necrosis. AJR Am J Roentgenol 2009, 192:110–116.CrossRefPubMed
23.
go back to reference • Seifert H, Biermer M, Schmitt W, et al.: Transluminal endoscopic necrosectomy after acute pancreatitis: a multicenter study with long-term follow-up (the GEPARD study). Gut 2009, 58:1260–1266. This study presents one of the largest case series to date that describes the experience with endoscopic necrosectomy of postnecrotic fluid collections from acute pancreatitis. • Seifert H, Biermer M, Schmitt W, et al.: Transluminal endoscopic necrosectomy after acute pancreatitis: a multicenter study with long-term follow-up (the GEPARD study). Gut 2009, 58:1260–1266. This study presents one of the largest case series to date that describes the experience with endoscopic necrosectomy of postnecrotic fluid collections from acute pancreatitis.
24.
go back to reference Telford JJ, Farrell JJ, Saltzman JR, et al.: Pancreatic stent placement for duct disruption. Gastrointest Endosc 2002, 56:18–24.CrossRefPubMed Telford JJ, Farrell JJ, Saltzman JR, et al.: Pancreatic stent placement for duct disruption. Gastrointest Endosc 2002, 56:18–24.CrossRefPubMed
25.
go back to reference Lawrence C, Howell DA, Stefan AM, et al.: Disconnected pancreatic tail syndrome: potential for endoscopic therapy and results of long-term follow-up. Gastrointest Endosc 2008, 67:673–679.CrossRefPubMed Lawrence C, Howell DA, Stefan AM, et al.: Disconnected pancreatic tail syndrome: potential for endoscopic therapy and results of long-term follow-up. Gastrointest Endosc 2008, 67:673–679.CrossRefPubMed
26.
go back to reference Williams DL, Ha T, Li C, et al.: Modulation of tissue Toll-like receptor 2 and 4 during the early phases of polymicrobial sepsis correlates with mortality. Crit Care Med 2003, 31:1808–1818.CrossRefPubMed Williams DL, Ha T, Li C, et al.: Modulation of tissue Toll-like receptor 2 and 4 during the early phases of polymicrobial sepsis correlates with mortality. Crit Care Med 2003, 31:1808–1818.CrossRefPubMed
27.
go back to reference Alves-Filho JC, de Freitas A, Russo M, Cunha FQ: Toll-like receptor 4 signaling leads to neutrophil migration impairment in polymicrobial sepsis. Crit Care Med 2006, 34:461–470.CrossRefPubMed Alves-Filho JC, de Freitas A, Russo M, Cunha FQ: Toll-like receptor 4 signaling leads to neutrophil migration impairment in polymicrobial sepsis. Crit Care Med 2006, 34:461–470.CrossRefPubMed
28.
go back to reference Besselink MG, van Santvoort HC, Buskens E, et al.: Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet 2008, 371:651–659.CrossRefPubMed Besselink MG, van Santvoort HC, Buskens E, et al.: Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet 2008, 371:651–659.CrossRefPubMed
29.
go back to reference Marik PE, Zaloga GP: Meta-analysis of parenteral nutrition versus enteral nutrition in patients with acute pancreatitis. BMJ 2004, 328:1407.CrossRefPubMed Marik PE, Zaloga GP: Meta-analysis of parenteral nutrition versus enteral nutrition in patients with acute pancreatitis. BMJ 2004, 328:1407.CrossRefPubMed
30.
go back to reference Petrov MS, Loveday BP, Pylypchuk RD, et al.: Systematic review and meta-analysis of enteral nutrition formulations in acute pancreatitis. Br J Surg 2009, 96:1243–1252.CrossRefPubMed Petrov MS, Loveday BP, Pylypchuk RD, et al.: Systematic review and meta-analysis of enteral nutrition formulations in acute pancreatitis. Br J Surg 2009, 96:1243–1252.CrossRefPubMed
31.
go back to reference Pezzilli R, Simoni P, Casadei R, Morselli-Labate AM: Exocrine pancreatic function during the early recovery phase of acute pancreatitis. Hepatobiliary Pancreat Dis Int 2009, 8:316–319.PubMed Pezzilli R, Simoni P, Casadei R, Morselli-Labate AM: Exocrine pancreatic function during the early recovery phase of acute pancreatitis. Hepatobiliary Pancreat Dis Int 2009, 8:316–319.PubMed
32.
go back to reference Symersky T, van Hoorn B, Masclee AA: The outcome of a long-term follow-up of pancreatic function after recovery from acute pancreatitis. JOP 2006, 7:447–453.PubMed Symersky T, van Hoorn B, Masclee AA: The outcome of a long-term follow-up of pancreatic function after recovery from acute pancreatitis. JOP 2006, 7:447–453.PubMed
33.
go back to reference Pelli H, Lappalainen-Lehto R, Piironen A, et al.: Pancreatic damage after the first episode of acute alcoholic pancreatitis and its association with the later recurrence rate. Pancreatology 2009, 9:245–251.CrossRefPubMed Pelli H, Lappalainen-Lehto R, Piironen A, et al.: Pancreatic damage after the first episode of acute alcoholic pancreatitis and its association with the later recurrence rate. Pancreatology 2009, 9:245–251.CrossRefPubMed
34.
go back to reference Wright SE, Lochan R, Imrie K, et al.: Quality of life and functional outcome at 3, 6 and 12 months after acute necrotising pancreatitis. Intensive Care Med 2009, 35:1974–1978.CrossRefPubMed Wright SE, Lochan R, Imrie K, et al.: Quality of life and functional outcome at 3, 6 and 12 months after acute necrotising pancreatitis. Intensive Care Med 2009, 35:1974–1978.CrossRefPubMed
35.
go back to reference Pezzilli R, Morselli-Labate AM, Campana D, et al.: Evaluation of patient-reported outcome in subjects treated medically for acute pancreatitis: a follow-up study. Pancreatology 2009, 9:375–382.CrossRefPubMed Pezzilli R, Morselli-Labate AM, Campana D, et al.: Evaluation of patient-reported outcome in subjects treated medically for acute pancreatitis: a follow-up study. Pancreatology 2009, 9:375–382.CrossRefPubMed
36.
go back to reference •• Nordback I, Pelli H, Lappalainen-Lehto R, et al.: The recurrence of acute alcohol-associated pancreatitis can be reduced: a randomized controlled trial. Gastroenterology 2009, 136:848–855. This randomized, controlled trial demonstrated a significant reduction in the recurrence of alcohol-associated pancreatitis with repeated 6-month interventions over a 2-year period. •• Nordback I, Pelli H, Lappalainen-Lehto R, et al.: The recurrence of acute alcohol-associated pancreatitis can be reduced: a randomized controlled trial. Gastroenterology 2009, 136:848–855. This randomized, controlled trial demonstrated a significant reduction in the recurrence of alcohol-associated pancreatitis with repeated 6-month interventions over a 2-year period.
37.
go back to reference Ito K, Ito H, Whang EE: Timing of cholecystectomy for biliary pancreatitis: do the data support current guidelines? J Gastrointest Surg 2008, 12:2164–2170.CrossRefPubMed Ito K, Ito H, Whang EE: Timing of cholecystectomy for biliary pancreatitis: do the data support current guidelines? J Gastrointest Surg 2008, 12:2164–2170.CrossRefPubMed
38.
go back to reference Chiang DT, Thompson G: Management of acute gallstone pancreatitis: so the story continues. ANZ J Surg 2008, 78:52–54.PubMedCrossRef Chiang DT, Thompson G: Management of acute gallstone pancreatitis: so the story continues. ANZ J Surg 2008, 78:52–54.PubMedCrossRef
39.
go back to reference Monkhouse SJ, Court EL, Dash I, Coombs NJ: Two-week target for laparoscopic cholecystectomy following gallstone pancreatitis is achievable and cost neutral. Br J Surg 2009, 96:751–755.CrossRefPubMed Monkhouse SJ, Court EL, Dash I, Coombs NJ: Two-week target for laparoscopic cholecystectomy following gallstone pancreatitis is achievable and cost neutral. Br J Surg 2009, 96:751–755.CrossRefPubMed
40.
go back to reference Nebiker CA, Frey DM, Hamel CT, et al.: Early versus delayed cholecystectomy in patients with biliary acute pancreatitis. Surgery 2009, 145:260–264.CrossRefPubMed Nebiker CA, Frey DM, Hamel CT, et al.: Early versus delayed cholecystectomy in patients with biliary acute pancreatitis. Surgery 2009, 145:260–264.CrossRefPubMed
41.
go back to reference Lankisch PG, Breuer N, Bruns A, et al.: Natural history of acute pancreatitis: a long-term population-based study. Am J Gastroenterol 2009, 104:2797–2805; quiz 2806. Lankisch PG, Breuer N, Bruns A, et al.: Natural history of acute pancreatitis: a long-term population-based study. Am J Gastroenterol 2009, 104:2797–2805; quiz 2806.
42.
go back to reference Yadav D, Hawes RH, Brand RE, et al.: Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis. Arch Intern Med 2009, 169:1035–1045.CrossRefPubMed Yadav D, Hawes RH, Brand RE, et al.: Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis. Arch Intern Med 2009, 169:1035–1045.CrossRefPubMed
43.
go back to reference Bang UC, Nojgaard C, Andersen PK, Matzen P: Meta-analysis: nitroglycerin for prevention of post-ERCP pancreatitis. Aliment Pharmacol Ther 2009, 29:1078–1085.CrossRefPubMed Bang UC, Nojgaard C, Andersen PK, Matzen P: Meta-analysis: nitroglycerin for prevention of post-ERCP pancreatitis. Aliment Pharmacol Ther 2009, 29:1078–1085.CrossRefPubMed
44.
go back to reference Rudin D: Somatostatin bolus injection for post-ERCP pancreatitis prevention: a need for further study. Gastrointest Endosc 2008, 67:190; author reply 190–191. Rudin D: Somatostatin bolus injection for post-ERCP pancreatitis prevention: a need for further study. Gastrointest Endosc 2008, 67:190; author reply 190–191.
45.
go back to reference Sherman S, Alazmi WM, Lehman GA, et al.: Evaluation of recombinant platelet-activating factor acetylhydrolase for reducing the incidence and severity of post-ERCP acute pancreatitis. Gastrointest Endosc 2009, 69(3 Pt 1):462–472.CrossRefPubMed Sherman S, Alazmi WM, Lehman GA, et al.: Evaluation of recombinant platelet-activating factor acetylhydrolase for reducing the incidence and severity of post-ERCP acute pancreatitis. Gastrointest Endosc 2009, 69(3 Pt 1):462–472.CrossRefPubMed
46.
go back to reference Sherman S, Cheng CL, Costamagna G, et al.: Efficacy of recombinant human interleukin-10 in prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis in subjects with increased risk. Pancreas 2009, 38:267–274.CrossRefPubMed Sherman S, Cheng CL, Costamagna G, et al.: Efficacy of recombinant human interleukin-10 in prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis in subjects with increased risk. Pancreas 2009, 38:267–274.CrossRefPubMed
47.
go back to reference Senol A, Saritas U, Demirkan H: Efficacy of intramuscular diclofenac and fluid replacement in prevention of post-ERCP pancreatitis. World J Gastroenterol 2009, 15:3999–4004.CrossRefPubMed Senol A, Saritas U, Demirkan H: Efficacy of intramuscular diclofenac and fluid replacement in prevention of post-ERCP pancreatitis. World J Gastroenterol 2009, 15:3999–4004.CrossRefPubMed
48.
go back to reference Singla A, Simons J, Li Y, et al.: Admission volume determines outcome for patients with acute pancreatitis. Gastroenterology 2009, 137:1995–2001.CrossRefPubMed Singla A, Simons J, Li Y, et al.: Admission volume determines outcome for patients with acute pancreatitis. Gastroenterology 2009, 137:1995–2001.CrossRefPubMed
Metadata
Title
Update in Acute Pancreatitis
Authors
Bechien U. Wu
Darwin L. Conwell
Publication date
01-04-2010
Publisher
Current Science Inc.
Published in
Current Gastroenterology Reports / Issue 2/2010
Print ISSN: 1522-8037
Electronic ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-010-0091-6

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