The incidence of acute pancreatitis is increasing in the UK,¹ with a current hospital admission rate of 9.8 per year per 100 000 population.¹ However, there has only been a marginal decrease in the overall one year case fatality rate, from 12.7% in 1975–86 to 11.8% in 1987–98.¹ Gall stones and alcohol are the main aetiological factors for acute pancreatitis.² Nearly 25% of episodes of acute pancreatitis are severe³ and approximately 45% of these are due to gall stones.²

The UK guidelines for the management of acute pancreatitis were formulated and released by the British Society of Gastroenterology (BSG) in 1998.⁴ MEDLINE, EMBASE, and the Cochrane databases were searched to find recent evidence in the management of acute pancreatitis. …