Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2023; 11(12): 2582-2603
Published online Apr 26, 2023. doi: 10.12998/wjcc.v11.i12.2582
Controversies in the management of acute pancreatitis: An update
Manish Manrai, Saurabh Dawra, Anupam K Singh, Daya Krishna Jha, Rakesh Kochhar
Manish Manrai, Department of Internal Medicine, Armed Forces Medical College, Pune 411040, India
Saurabh Dawra, Department of Medicine and Gastroenterology, Command Hospital, Pune 411040, India
Anupam K Singh, Rakesh Kochhar, Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Daya Krishna Jha, Department of Gastroenterology, Army Hospital (Research and Referral), New Delhi 11010, India
Author contributions: Manrai M conceptualized the review and was involved with resources, formal analysis, data curation, writing, review and editing; Dawra S, Singh AK and Jha DK were involved with resources, formal analysis, data curation, writing; Kochhar R was involved in resources, validation and editing.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
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: Manish Manrai, FRCPE, MBBS, MD, Professor, Department of Internal Medicine, Armed Forces Medical College, Solapur Road, Pune 411040, India. manishmanrai@yahoo.com
Received: November 27, 2022
Peer-review started: November 27, 2022
First decision: December 27, 2022
Revised: January 22, 2023
Accepted: March 29, 2023
Article in press: March 29, 2023
Published online: April 26, 2023
Processing time: 149 Days and 7.2 Hours
Core Tip

Core Tip: The controversies in the management of acute pancreatitis are an area of dynamic research, and emerging data is assisting in guideline formulation. The current evidence favors crystalloids, although the choice and type of fluid resuscitation is an evolving research area. The empirical use of antibiotics and antifungals are gray zones and lack guidelines. The choice of analgesic lacks definite recommendations. The role of anticoagulation lacks agreement. The role of intervention is well established and favors endoscopy or percutaneous drainage rather than surgery. It is obvious that more evidence is essential for effective guidelines in these critical management issues of acute pancreatitis.