Preface

These guidelines on the management of acute pancreatitis were commissioned by the British Society of Gastroenterology. They have been endorsed by the Clinical Services Committee of the British Society of Gastroenterology, the Association of Upper Gastro-Intestinal Surgeons of Great Britain and Ireland, the Pancreatic Society of Great Britain and Ireland, and the Association of Surgeons of Great Britain and Ireland.

The guidelines address the initial steps in diagnosis, investigation and treatment of acute pancreatitis, but stop short of the specific surgical management of complex cases. The nature of acute pancreatitis with its wide variation of severity and complications means that rigid guidelines may be inappropriate and difficult to apply. Thus, although these guidelines attempt to describe the highest standard of care and set audit goals, a large element of independent clinical decision making is still required. A further factor relates to the availability of local resources and expertise in the management of acute pancreatitis and this is addressed with reference to specialist units.

The list of clinicians from different specialities who are directly responsible for these guidelines together with those who were consulted at a later stage of their production is given at the beginning of this supplement. The modus operandi of the group is given within the text. These guidelines were finalised in April 1997 and will need to be revised in two years time.

Introduction and purpose of guidelines

During recent years there have been many changes in the management of patients with acute pancreatitis. These have included the general availability of computed tomography (CT) scanning, interventional radiological procedures, refinements in ITU care, and a more aggressive surgical policy in those with infected necrosis. Despite these measures, the overall mortality has remained unaltered at around 10–15% for the past two decades.1 ,2 Multicentre audits have revealed deficiencies in the management of …