Mistakes in the management of acute pancreatitis and how to avoid them

Filters:

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in the management of acute pancreatitis and how to avoid them

Peter Simon, Markus M. Lerch, Julia Mayerle, Georg Beyer, Elisabeth Orgler-Gasche

Summary

AI Generated

Acute pancreatitis is most commonly caused by alcohol and gallstones, with 80–85% of cases being mild while the remainder require intensive multidisciplinary care for potentially life-threatening complications.

Excessive alcohol consumption and gallstone disease are by far the most common risk factors for acute pancreatitis, while certain drugs, genetic mutations, and possibly smoking are also associated with its development
80–85% of patients have mild disease and recover with fluid therapy and analgesia, while the remainder develop moderately severe to severe disease with pancreatic necrosis, severe sepsis, or abdominal compartment syndrome
Patients with severe disease are at immediate danger of multiorgan failure and death and require multidisciplinary intensive care, organ support, and often pancreatic interventions by experienced investigators
Treatment in specialized high-volume centres is recommended because outcomes are difficult to predict and complications develop during the disease course

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

By far the most common risk factors for the development of acute pancreatitis are excessive alcohol consumption and gallstone disease. Several mutations have been identified that, in combination with nongenetic factors or alone, can lead to pancreatitis. Certain drugs are known to be associated with the development of pancreatitis and smoking might also increase the probability of it developing. 80–85% of patients diagnosed with the disease will have mild disease and make an uneventful recovery with little more than adequate fluid therapy and analgesia needed to support them. The remaining patients, however, will suffer from moderately severe to severe acute pancreatitis, with the development of pancreatic necrosis, severe sepsis or abdominal compartment syndrome. These patients are at immediate danger of multiorgan failure and death and require multidisciplinary intensive care, organ support and often pancreatic interventions conducted by experienced investigators. Since it is difficult to predict outcomes and complications develop during the disease course, treatment in specialized centres that have a high case load is recommended.4

Topics

Pancreas

Citation

Beyer G, et al. Mistakes in the management of acute pancreatitis and how to avoid them. UEG Education 2016: 16: 27–30.

Published

2024

More Like This:

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG

Miroslav Vujasinovic

Mistakes in alcoholic liver disease and how to avoid them

Helena Cortez-Pinto

European Consensus Recommendations for Direct Cholangioscopy and Pancreatoscopy Using a Modified Delphi Process

Sebastian Stefanovic

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Pancreatic cystic neoplasms with Marco del Chiaro

Egle Dieninyte - Misiune

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in the management of peritoneal malignancies and how to avoid them

Francesco Saverio Papadia, Matteo Santoliquido, Andrea Barberis, Tarkan Jäger, Charlotte Rabl

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Peritoneal malignancies represent a complex and often misjudged clinical challenge. Historically synonymous with a terminal diagnosis, the advent of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) radically altered the prognosis for selected patients. However, progress has been jeopardised by a series of recurring and preventable errors in diagnosis, staging, and treatment selection. This article delineates the ten most critical pitfalls in managing peritoneal surface malignancies. For each pitfall, we provide evidence-based explanations, concrete clinical examples, and strategic recommendations for avoidance. We emphasise the pivotal role of early multidisciplinary discussion, precise imaging, and timely referral to high-volume expert centres to optimise patient outcomes and offer curative intent where previously there was none.

Topics

Digestive Oncology Surgery

Published

2026

More Like This:

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG

Miroslav Vujasinovic

Mistakes in alcoholic liver disease and how to avoid them

Helena Cortez-Pinto

European Consensus Recommendations for Direct Cholangioscopy and Pancreatoscopy Using a Modified Delphi Process

Sebastian Stefanovic

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Pancreatic cystic neoplasms with Marco del Chiaro

Egle Dieninyte - Misiune

UEG Standards and Guidelines

Consensus

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG

Miroslav Vujasinovic

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Guideline

ABSTRACT

This international, multidisciplinary consensus report represents the first effort to systematically define and characterize fatty pancreas. A key outcome of this endeavor was the recommendation to adopt “fatty pancreas” as the standardized and inclusive term to describe all forms of fat accumulation in the pancreas. This terminological consensus provides a critical foundation for unified reporting and clinical communication. Another major contribution of the report is the consensus on diagnostic imaging findings, which was based on radiological and endoscopic modalities. The proposed criteria aim to enhance consistency in clinical assessment and support the development of standardized research protocols. In addition to establishing terminology and diagnostic frameworks, the report also synthesizes current knowledge across a wide range of relevant domains. These include the etiology and epidemiology of fatty pancreas, as well as its associations with alcohol consumption, smoking, acute and chronic pancreatitis, pancreatic exocrine insufficiency, type 2 diabetes mellitus, and surgical outcomes. The potential links between fatty pancreas and neoplastic conditions such as intraductal papillary mucinous neoplasms and pancreatic cancer are also addressed, alongside the current understanding of its metabolic implications (beta-cell function and glucose homeostasis) and treatment strategies. Throughout the consensus process, a consistent theme emerged: the limited availability of high-quality, prospective clinical data. Therefore, many of the recommendations in this report are based on expert consensus rather than strong empirical evidence. As such, the statements require rigorous prospective validation before they can be adopted into routine clinical practice. This underscores a critical need for further research, particularly studies aimed at clarifying causal relationships, validating diagnostic tools, and determining the clinical relevance of fatty pancreas across diverse patient populations. This report serves as both a summary of our current understanding and a roadmap for future investigations, aiming to close existing knowledge gaps and guide evidence-based clinical practice in this emerging field.

Publishers

European Society for Paediatric Gastroenterology, Hepatology and Nutrition, The European Society for Clinical Nutrition and Metabolism, European Society for Primary Care Gastroenterology, European Society of Pathology, European Society of Gastrointestinal Endoscopy, European Society of Gastrointestinal and Abdominal Radiology, European Association for the Study of the Liver, European Pancreatic Club

Guideline

Consensus

Topics

Pancreas

Citation

United European Gastroenterology Journal, 2026; 14:e70185

Published

2026

More Like This:

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG

Miroslav Vujasinovic

Mistakes in alcoholic liver disease and how to avoid them

Helena Cortez-Pinto

European Consensus Recommendations for Direct Cholangioscopy and Pancreatoscopy Using a Modified Delphi Process

Sebastian Stefanovic

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Pancreatic cystic neoplasms with Marco del Chiaro

Egle Dieninyte - Misiune

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in alcoholic liver disease and how to avoid them

Helena Cortez-Pinto, Pedro Marques Da Costa

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Alcohol consumption is the most prevalent aetiology for liver cirrhosis in Europe and the third leading risk factor for overall mortality.1,2 In fact, alcoholic liver cirrhosis accounts for almost half a million deaths a year worldwide, corresponding to 50% of all cases of cirrhosis, according to the World Health Organization (WHO).3 Alcoholic liver disease (ALD) is multifaceted, with several cofactors influencing its progression. Patients abusing alcohol can simultaneously have viral hepatitis B or C, or a genetic disease, such as alpha-1 antitrypsin deficiency or haemochromatosis.

Topics

Hepatobiliary

Citation

Marques da Costa P and Cortez-Pinto H. Mistakes in alcoholic liver disease and how to avoid them. UEG Education 2017: 17; 10–14.

Published

2024

More Like This:

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG

Miroslav Vujasinovic

Mistakes in alcoholic liver disease and how to avoid them

Helena Cortez-Pinto

European Consensus Recommendations for Direct Cholangioscopy and Pancreatoscopy Using a Modified Delphi Process

Sebastian Stefanovic

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Pancreatic cystic neoplasms with Marco del Chiaro

Egle Dieninyte - Misiune

UEG Standards and Guidelines

Consensus

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

European Consensus Recommendations for Direct Cholangioscopy and Pancreatoscopy Using a Modified Delphi Process

Enrico Palmeri, Sebastian Stefanovic

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Guideline

ABSTRACT

Background and Aim

Direct cholangioscopy and pancreatoscopy have become widely implemented techniques in the diagnostic and therapeutic algorithms of several pancreaticobiliary disorders. This study aimed to generate general and indication-specific European consensus recommendations on cholangioscopy and pancreatoscopy.

Methods

Supported by the available literature, statements were formulated and grouped into the following categories: (1) pre-procedural considerations, (2) general technical aspects, (3) biliopancreatic stones, (4) biliary strictures, and (5) other indications. The evidence level of each statement was determined using the GRADE methodology. Cholangioscopy experts were invited to participate in a modified Delphi process. When 80% consensus was not reached, the statement was modified based on expert feedback and subjected to an additional Delphi round. Statements were rejected if they failed to reach consensus after three Delphi rounds.

Results

Thirty cholangioscopy experts completed the Delphi process. Forty-two (97.6%) generated statements were accepted, of which 39 (92.9%) in the first Delphi round. 12 statements on preprocedural and periprocedural settings, 8 statements on biliopancreatic stones, 13 statements on biliary strictures, and 9 statements on other indications were accepted.

Conclusion

Using a modified Delphi process, we developed general and indication-specific consensus recommendations for cholangioscopy to guide clinical practice.

Guideline

Consensus

Topics

Endoscopy Pancreas

Citation

United European Gastroenterology Journal, 2025; 13:1652–1667

Published

2025

More Like This:

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG

Miroslav Vujasinovic

Mistakes in alcoholic liver disease and how to avoid them

Helena Cortez-Pinto

European Consensus Recommendations for Direct Cholangioscopy and Pancreatoscopy Using a Modified Delphi Process

Sebastian Stefanovic

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Pancreatic cystic neoplasms with Marco del Chiaro

Egle Dieninyte - Misiune

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Alteration of common coagulation tests and thrombocytopenia represent an integral part of the clinical picture of patients with advanced chronic liver disease. As such, the International Normalised Ratio (INR) for prothrombin time is part of the Model for End-stage Liver Disease (MELD) score, which is commonly used to assess prognosis and the need for liver transplantation in patients with cirrhosis. Thrombocytopenia—being mainly related to hypersplenism and decreased synthesis of thrombopoietin by the liver—can also be used to identify the presence of portal hypertension and decreased liver function in patients with chronic liver disease.

Topics

Hepatobiliary

Citation

Giannini EG and Caldwell SH. Mistakes in coagulation in liver disease and how to avoid them. UEG Education 2021; 21: 29–34.

Published

2021

More Like This:

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG

Miroslav Vujasinovic

Mistakes in alcoholic liver disease and how to avoid them

Helena Cortez-Pinto

European Consensus Recommendations for Direct Cholangioscopy and Pancreatoscopy Using a Modified Delphi Process

Sebastian Stefanovic

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Pancreatic cystic neoplasms with Marco del Chiaro

Egle Dieninyte - Misiune

UEG Podcast Episode

UEG Podcast

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Pancreatic cystic neoplasms with Marco del Chiaro

Marco Del Chiaro, Egle Dieninyte - Misiune

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Topics

Pancreas

Published

2025

More Like This:

Mistakes in the management of peritoneal malignancies and how to avoid them

Charlotte Rabl

International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG

Miroslav Vujasinovic

Mistakes in alcoholic liver disease and how to avoid them

Helena Cortez-Pinto

European Consensus Recommendations for Direct Cholangioscopy and Pancreatoscopy Using a Modified Delphi Process

Sebastian Stefanovic

Mistakes in coagulation in liver disease and how to avoid them

Edoardo G. Giannini

Pancreatic cystic neoplasms with Marco del Chiaro

Egle Dieninyte - Misiune