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IAP/APA evidence-based guidelines for the management of acute pancreatitis

(2013) PANCREATOLOGY. 13(4, suppl 2). p.E1-E15
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Abstract
Background: There have been substantial improvements in the management of acute pancreatitis since the publication of the International Association of Pancreatology (IAP) treatment guidelines in 2002. A collaboration of the IAP and the American Pancreatic Association (APA) was undertaken to revise these guidelines using an evidence-based approach. Methods: Twelve multidisciplinary review groups performed systematic literature reviews to answer 38 predefined clinical questions. Recommendations were graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The review groups presented their recommendations during the 2012 joint IAP/APA meeting. At this one-day, interactive conference, relevant remarks were voiced and overall agreement on each recommendation was quantified using plenary voting. Results: The 38 recommendations covered 12 topics related to the clinical management of acute pancreatitis: A) diagnosis of acute pancreatitis and etiology, B) prognostication/predicting severity, C) imaging, D) fluid therapy, E) intensive care management, F) preventing infectious complications, G) nutritional support, H) biliary tract management, I) indications for intervention in necrotizing pancreatitis, J) timing of intervention in necrotizing pancreatitis, K) intervention strategies in necrotizing pancreatitis, and L) timing of cholecystectomy. Using the GRADE system, 21 of the 38 (55%) recommendations, were rated as 'strong' and plenary voting revealed 'strong agreement' for 34 (89%) recommendations. Conclusions: The 2012 IAP/APA guidelines provide recommendations concerning key aspects of medical and surgical management of acute pancreatitis based on the currently available evidence. These recommendations should serve as a reference standard for current management and guide future clinical research on acute pancreatitis.
Keywords
Acute pancreatitis, Pancreas, Guidelines, Diagnosis, Prediction, Prevention, Treatment, Intervention, Nutrition, Surgery, Radiology, Gastroenterology

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Chicago
Besselink, Marc, Hjalmar van Santvoort, Martin Freeman, Timothy Gardner, Julia Mayerle, Santhi Swaroop Vege, Jens Werner, et al. 2013. “IAP/APA Evidence-based Guidelines for the Management of Acute Pancreatitis.” Pancreatology 13 (4, suppl 2): E1–E15.
APA
Besselink, M., van Santvoort, H., Freeman, M., Gardner, T., Mayerle, J., Vege, S. S., Werner, J., et al. (2013). IAP/APA evidence-based guidelines for the management of acute pancreatitis. PANCREATOLOGY, 13(4, suppl 2), E1–E15.
Vancouver
1.
Besselink M, van Santvoort H, Freeman M, Gardner T, Mayerle J, Vege SS, et al. IAP/APA evidence-based guidelines for the management of acute pancreatitis. PANCREATOLOGY. 2013;13(4, suppl 2):E1–E15.
MLA
Besselink, Marc, Hjalmar van Santvoort, Martin Freeman, et al. “IAP/APA Evidence-based Guidelines for the Management of Acute Pancreatitis.” PANCREATOLOGY 13.4, suppl 2 (2013): E1–E15. Print.
@article{8582111,
  abstract     = {Background: There have been substantial improvements in the management of acute pancreatitis since the publication of the International Association of Pancreatology (IAP) treatment guidelines in 2002. A collaboration of the IAP and the American Pancreatic Association (APA) was undertaken to revise these guidelines using an evidence-based approach. 
Methods: Twelve multidisciplinary review groups performed systematic literature reviews to answer 38 predefined clinical questions. Recommendations were graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The review groups presented their recommendations during the 2012 joint IAP/APA meeting. At this one-day, interactive conference, relevant remarks were voiced and overall agreement on each recommendation was quantified using plenary voting. 
Results: The 38 recommendations covered 12 topics related to the clinical management of acute pancreatitis: A) diagnosis of acute pancreatitis and etiology, B) prognostication/predicting severity, C) imaging, D) fluid therapy, E) intensive care management, F) preventing infectious complications, G) nutritional support, H) biliary tract management, I) indications for intervention in necrotizing pancreatitis, J) timing of intervention in necrotizing pancreatitis, K) intervention strategies in necrotizing pancreatitis, and L) timing of cholecystectomy. Using the GRADE system, 21 of the 38 (55\%) recommendations, were rated as 'strong' and plenary voting revealed 'strong agreement' for 34 (89\%) recommendations. 
Conclusions: The 2012 IAP/APA guidelines provide recommendations concerning key aspects of medical and surgical management of acute pancreatitis based on the currently available evidence. These recommendations should serve as a reference standard for current management and guide future clinical research on acute pancreatitis.},
  author       = {Besselink, Marc and van Santvoort, Hjalmar and Freeman, Martin and Gardner, Timothy and Mayerle, Julia and Vege, Santhi Swaroop and Werner, Jens and Banks, Peter and McKay, Colin and Fernandez-del Castillo, Carlos and French, Jeremy and Gooszen, Hein and Johnson, Colin and Sarr, Mike and Takada, Tadahiro and Windsor, John and Saluja, Ashok and Liddle, Rodger and Papachristou, Georgios and Singh, Vijay and Ruenzi, Michael and Wu, Bechien and Singh, Vikesh and Bollen, Thomas and Morgan, Desiree and Mortele, Koenraad and Mittal, Anubhav and En-qiang, Mao and De Waele, Jan and Petrov, Maxim and Dellinger, Patchen and Lerch, Markus M and Anderson, Roland and McClave, Stephen and Hartwig, Werner and Bruno, Marco and Oria, Alejandro and Baron, Todd and Fagenholz, Peter and Horvath, Karen and van Baal, Mark and Nealon, William and Andren-Sandberg, Ake and Bakker, Olaf and Bassi, Claudio and Buchler, Markus and Boermeester, Marja and Bradley, Ed and Chari, Suresh and Charnley, Richard and Connor, Saxon and Dervenis, Christos and Deviere, Jacques and Dudeja, Vikas and Fockens, Paul and Forsmark, Chris and Friess, Helmut and Isaji, Shuji and Isenmann, Rainer and Klar, Ernst and Levy, Philippe and Lillemoe, Keith and Liu, Xubao and Loehr, Chengdu Matthias and Mayumi, Toshihiko and Mossner, Joachim and Neoptolemos, John and Nordback, Isto and Olah, Attila and Padbury, Roy and Parks, Rowan and Radenkovic, Dejan and Rau, Bettina and Rebours, Vinciane and Seewald, Stefan and Seifert, Hans and Shimosegawa, Tooru and Siriwardena, Ajith and Steinberg, William and Sutton, Robert and Tanaka, Masao and Takeda, Kazunori and Tse, Francis and van Goor, Harry and Warshaw, Andrew and Wang, Chunyou and Whitcomb, David and Zhao, Yupei and Zyromski, Nicholas},
  issn         = {1424-3903},
  journal      = {PANCREATOLOGY},
  language     = {eng},
  number       = {4, suppl 2},
  pages        = {E1--E15},
  title        = {IAP/APA evidence-based guidelines for the management of acute pancreatitis},
  url          = {http://dx.doi.org/10.1016/j.pan.2013.07.063},
  volume       = {13},
  year         = {2013},
}

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