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Inicio Gastroenterología y Hepatología (English Edition) Evaluation and management of acute pancreatitis in Spain
Journal Information
Vol. 41. Issue 10.
Pages 618-628 (December 2018)
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Vol. 41. Issue 10.
Pages 618-628 (December 2018)
Original article
DOI: 10.1016/j.gastre.2018.11.025
Evaluation and management of acute pancreatitis in Spain
Evaluación y manejo de pancreatitis aguda en España
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Francisco Valverde-Lópeza,
Corresponding author
fcovalverde89@gmail.com

Corresponding author.
, C. Mel Wilcoxb, Eduardo Redondo-Cerezoa
a Department of Gastroenterology and Hepatology, “Virgen de las Nieves” University Hospital, Complejo Hospitalario Universitario de Granada, Granada, Spain
b Division of Gastroenterology and Hepatology and Pancreaticobiliary Center, University of Alabama at Birmingham, USA
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Figures (1)
Tables (4)
Table 1. Patients characteristics in studies in which etiology is completely described.
Table 2. Diagnostic yield of EUS in diagnosis of Idiopathic Acute Pancreatitis.
Table 3. Comparison between the Revised Atlanta Classification, Determinant-Based Classification, and the Modified Determinant-Based Classification (Epidemiology of Acute Pancreatitis in Intensive Care Medicine Study Group, Zubia-Olaskoaga et al.).
Table 4. Predictors of poor outcomes in acute pancreatitis.
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Abstract
Introduction

The aim of this systematic review is to summarize epidemiological data and areas of future acute pancreatitis research in Spain.

Methods

We conduct an independent search in PubMed and Web of Science and analyse articles by Spanish researchers from 2008 to 2018.

Results

We identified an overall incidence of 72/100,000 person-years, with biliary pancreatitis as the most common etiology. BISAP was useful but suboptimal for predicting severity and some biomarkers such as Oleic acid chlorohydrin have shown promising results. The modified determinant-based classification can help to classify patients admitted to intensive care units. Ringer's lactate solution is currently the fluid of choice and classic surgery has been surpassed by minimally-invasive approaches. Starting a full-caloric diet is safe when bowel sounds are present.

Discussion

There are numerous well-defined research fields in Spain. Future multicentre studies should focus on management, predicting severity and cost-effectiveness.

Keywords:
Acute pancreatitis
Epidemiology
Predicting severity
Management
Spain
Abbreviations:
AP
SAP
ICU
ACG
SIRS
EUS
MRCP
CEUS
CT
BUN
APACHE
BISAP
AIM 2
TLR
CRP
NF-kB
ERCP
NSAID
PDGF
HGF
Resumen
Introducción

El objetivo de esta revisión sistemática es sintetizar datos epidemiológicos y campos de investigación en pancreatitis aguda en España.

Métodos

Realizamos una búsqueda independiente en PubMed y Web of Science, analizando artículos de investigadores españoles desde 2008 hasta 2018.

Resultados

La incidencia global fue de 72/100.000 personas/año, siendo la etiología biliar la más común. BISAP resultó útil, aunque subóptimo en predicción de gravedad y ciertos biomarcadores como el ácido oleico clorhídrico han mostrado resultados prometedores. La clasificación basada en determinantes modificada puede ayudar en la clasificación de pacientes ingresados en UCI. La sueroterapia basada en Ringer lactato es actualmente de elección y la cirugía tradicional ha sido sustituida por abordajes mínimamente invasivos. La dieta amplia de inicio, cuando los ruidos intestinales están presentes es segura.

Discusión

Existen múltiples áreas de investigación bien definidas en España. Futuros estudios multicéntricos deberían centrarse en manejo, predicción de la gravedad y el coste/efectividad.

Palabras clave:
Pancreatitis aguda
Epidemiología
Predicción de gravedad
Manejo
España

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