Ann Clin Surg | Volume 3, Issue 1 | Research Article | Open Access

Acute Pancreatitis, Updated Best Practices Based Management Compared to Professional Guidelines Statements: Literature Review & Recommendations

Mohamed Mahmood Nasr*, Maged Mahmoud Nasr and Lamia Hamid Shehata

1Department of Endoscopic & General Surgery, King Fahd Medical City, KSA 2Department of Endoscopic Surgery, Obstetrics & Gynecology, Mazahmiya Hospital, KSA 3Department of Radiology, National Care Hospital, KSA

*Correspondance to: Mohamed Mahmood Nasr 

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Abstract

Objectives: Several clinical guidelines exist for acute pancreatitis, with varying recommendations. The aim of this study is to determine the quality of guidelines for acute pancreatitis and comparison to the updated best practices. Finally suggestion of best way of clinical management. Methods: First, literature search has identified relevant acute pancreatitis management guidelines, were then reviewed to determine their document format and scope and the presence of endorsement by a professional body. The quality of fifty five guidelines is determined using the validated “Grading of Recommendations Assessment, Development and Evaluation” hierarchy of evidence. The second, literature review for updated best practices’ management of acute pancreatitis and related complications. Finally, proposal for a structured best results’ management proposal for acute pancreatitis has been achieved. Results: Fifty five guidelines endorsed by professional bodies are analyzed regarding evidence quality that is found not improved over time. Guidelines with tables, a recommendations summary, evidence grading, and audit goals had significantly higher scores than guidelines lacking those features. Guidelines have not been a sharp cut for decision making regarding diagnosis, prediction of complication or treatment in addition of being not strictly followed. Updated best practices have accumulated over time and postulated a new conceptual approach competency. Conclusion: The many clinical guidelines for acute pancreatitis range widely regarding statements’ quality. Updated best practices management procedures for acute pancreatitis should be observed by professional bodies to consider valued one into the guidelines. Further dynamic wide scale research is required to determine whether guideline quality alters clinical outcomes

Keywords:

Guideline for acute pancreatitis; Hepato-bilio-pancreatic professional bodies; Grading of Recommendations Assessment Development and Evaluation (GRADE); Sequential organ failure assessment (SOFA); Determinant-Based Classification for the severity (DBC); Visual Analogue Scale (VAS)

Citation:

Mohamed Mahmood Nasr, Department of Endoscopic & General Surgery, King Fahd Medical City, Riyadh, Head of Research Unit, Directorate of Specialized Medical Centers, Ministry of Health, KSA, Tel: +966 543 606 109.

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