Acute pancreatitis between practice and recommendations

Abstract

Background: Acute inflammation of the pancreas, acute pancreatitis (AP) shows an increasing incidence in the world as well as in Algeria. However, lethality and mortality are decreasing, mainly due to recommendations from Atlanta, the International Pancreatology Association, and the American Pancreatology Association. The purpose of this work was to analyze the management of AP in the general surgery department of the UHC of Sidi Bel Abbes.

Method: In a retrospective study, 100 acute pancreatitis cases admitted to general surgery between January 2017 and December 2019 were analyzed.

The abdominal scanner was systematic at the admission. The rate of lipasemia, when greater than 3 times the normal one, allowed, in association with the evocative pain, to make the diagnosis. The severity of AP was assessed using the Balthazar score. An MRI was requested when the scanner was inconclusive, to look for an etiology and / or possible complications. Seventy-nine (79%) patients received broad-spectrum antibiotic therapy and diet was systematic.

Results: We have transmitted the recommendations of scholar societies to the various specialists and the management of AP is currently more unified and more effective. Scanner is no longer systematic in the early phase. Antibiotic therapy is no longer administered without biological evidence. Enteral nutrition is now possible.

Conclusion: We were able to reach the goal of reducing hospitalization and scanning requests. A further analysis of 100 other PA files is planned to confirm the obtained results.