Changes in diagnostic and therapeutic standards of acute pancreatitis in the clinical practice

Abstract

Epidemiological data analysis of a tertiary (regional) medical and surgical center. Diagnostic and therapeutic standards of patients with acute pancreatitis have changed significantly in the last few decades. Progress in laboratory and imaging diagnostics and achievements in experimental research resulted in a significant modification of the guidelines related to the care of pancreatitic patients. The aim was to analyse and compare the data of patients with acute pancreatitis treated in 1996 (period I) and 2004 (period II) at the Departments of Internal Medicine and Surgery, University of Szeged, to evaluate the concordance with international guidelines during medical and surgical treatment. Results: The authors analysed the clinical data of 126 and 124 patients, respectively, with acute pancreatitis observed during the two periods. An increase in the incidence of biliary acute pancreatitis, more frequent use of antibiotics, a higher frequency of therapeutic endoscopies (papillotomy and biliary stone extraction), the general application of ultrasonography-guided fine needle aspiration and bacterial culturing in cases of suspected infected necrosis, and higher effectiveness in complex surgical and supportive management of infected necrosis cases were detected in period II. Conclusion: Although most of the achievements suggested in international guidelines on medical/endoscopic and surgical treatment of acute pancreatitis have been implemented during the observation period, no significant changes in the morbidity and mortality data of patients were found.