[Assessment of the treatment of acute pancreatitis].

INTRODUCTION

The first international evidence-based guidelines for the management of acute pancreatitis were published in 1998. The aim of this study was to compare the care giving to patients with these guidelines.

MATERIAL AND METHODS

During the period, June 1996 to May 1999, a survey was carried out of all patients with acute pancreatitis six months after discharge.

RESULTS

One hundred and fifty-five patients with a first attack were identified within 48 hours (goal: 100%). Fifty (32%) had gallstones identified. Fifty-one (32%) were severe cases with ten (20%) deaths (goal: < 30%). The overall mortality (6.4%) was within the goal of less than 10%. Objective severity stratification (Ranson scoring) was performed in 94% (goal: 100%), and in severe cases 82% (goal: 100%) had a CT. In severe gallstone pancreatitis, 90% (goal: 100%) underwent an early ERCP (< 72 hours after admission). One management goal was not met: in mild cases, only 20-25% (goal: 100%) with gallstone pancreatitis were given definitive treatment within four weeks.

DISCUSSION

The treatment we offer our patients with acute pancreatitis is optimal--apart from one standard--when compared with international guidelines, but in spite of this exception the mortality rate is low.