Initial management of acute pancreatitis

Abstract

The management of acute pancreatitis (AP) has undergone significant changes in recent years, driven by new research that challenges previous practices. Moderate-intensity, targeted fluid therapy is now favoured over more aggressive strategies. While evidence on the ideal type of fluid is limited, lactated Ringer's solution may be associated with better outcomes. Effective pain control and early oral nutrition, when possible, are key components of treatment. Antibiotic use should be limited to proven or highly suspected infections, avoiding prophylactic use. Urgent endoscopic retrograde cholangiopancreatography (ERCP) is indicated in patients with acute cholangitis. Cholecystectomy performed during the same admission for mild biliary AP is safe and effectively prevents relapses.

Keywords: acute pancreatitis, management, prognosis.