Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2022; 14(11): 1179-1197
Published online Nov 27, 2022. doi: 10.4240/wjgs.v14.i11.1179
Diagnosis, severity stratification and management of adult acute pancreatitis–current evidence and controversies
Kai Siang Chan, Vishal G Shelat
Kai Siang Chan, Vishal G Shelat, Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
Vishal G Shelat, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
Vishal G Shelat, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
Author contributions: Chan KS is involved in the conceptualization and drafting of the initial manuscript; Shelat VG is involved in the conceptualization, supervision and revision of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Kai Siang Chan, MBBS, Doctor, Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore. kchan023@e.ntu.edu.sg
Received: September 11, 2022
Peer-review started: September 11, 2022
First decision: September 26, 2022
Revised: October 8, 2022
Accepted: October 25, 2022
Article in press: October 25, 2022
Published online: November 27, 2022
Processing time: 75 Days and 5.7 Hours
Core Tip

Core Tip: Acute pancreatitis (AP) is a dynamic and evolving pathology with unpredictable natural course and no specific therapy. Most patients have mild and self-limiting AP where supportive therapy is sufficient. Still, an estimated 20% of patients may have severe AP that consumes healthcare resources and contributes to mortality risk. Risk stratification tools guide clinicians in resource allocation, patient counselling, and clinical audit. A multidisciplinary approach including evidence-based care is integral for good clinical outcomes. With regards to necrotizing pancreatitis, too much, too early and too little, too late should be avoided, and step-up philosophy of intervention should be adopted.