Strum WB, Boland CR. Advances in acute and chronic pancreatitis. World J Gastroenterol 2023; 29(7): 1194-1201 [PMID: 36926670 DOI: 10.3748/wjg.v29.i7.1194]
Corresponding Author of This Article
Williamson B Strum, MD, Research Scientist, Department of Gastroenterology, Scripps Clinic, No. 10666 N Torrey Pines Road, La Jolla, CA 92037, United States. williamsonstrum@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Feb 21, 2023; 29(7): 1194-1201 Published online Feb 21, 2023. doi: 10.3748/wjg.v29.i7.1194
Advances in acute and chronic pancreatitis
Williamson B Strum, Clement Richard Boland
Williamson B Strum, Department of Gastroenterology, Scripps Clinic, La Jolla, CA 92037, United States
Clement Richard Boland, Department of Medicine, University of California San Diego, La Jolla, CA 92037, United States
Author contributions: Strum WB and Boland CR were equal contributors to the manuscript.
Conflict-of-interest statement: There are no conflicts of interest to report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Williamson B Strum, MD, Research Scientist, Department of Gastroenterology, Scripps Clinic, No. 10666 N Torrey Pines Road, La Jolla, CA 92037, United States. williamsonstrum@yahoo.com
Received: November 15, 2022 Peer-review started: November 15, 2022 First decision: January 2, 2023 Revised: January 18, 2023 Accepted: February 14, 2023 Article in press: February 14, 2023 Published online: February 21, 2023 Processing time: 98 Days and 6 Hours
Abstract
Acute pancreatitis (AP) and chronic pancreatitis are the third leading gastrointestinal causes for admissions and readmissions to hospitals in the United States. This review of articles published between 2019-2022 (December) from international sources identified four categories of crucial new findings: The report includes (1) New genetic pathogenic mutations (TRPV6); expected genetic outcomes in a Northern European population; (2) a new serum diagnostic marker for AP-fatty acid ethyl esters-distinguishing acute pancreatitis associated with alcohol; explanations of the impact of monocytes/macrophages on the inflammatory process that defines their future in diagnosis, staging, and treatment; (3) innovations in timing of per os low-fat, solid food intake immediately on admission; resolution of concepts of aggressive parenteral fluid intake; dramatic shifts to non-operative from operative treatment of infected pancreatic necrosis. Each modification reduced interventions, complications, and lengths-of-stay; and (4) authoritarian recommendations for medical treatment of chronic pain. These advances offer opportunities to initiate newly proven treatments to enhance outcomes, alter the natural history, and envision the future of two diseases that have no known cure.
Core Tip: Acute and chronic pancreatitis are leading causes for admissions to hospitals. This review identified four categories of crucial new findings including: (1) New genetic mutations (TRPV6); expected genetic outcomes; (2) new serum diagnostic markers-distinguishing pancreatitis associated with alcohol, and defining the impact of monocytes/macrophages on the inflammatory process; (3) critical innovations: In timing of PO low-fat, solid food intake immediately on admission; resolved concepts on fluid intake; non-operative treatment of infected necrosis; and (4) authoritarian recommendations for treatment of chronic pain. These advances offer opportunities to initiate newly-proven treatments to enhance outcomes and alter the natural history.
