Mistakes in acute jaundice 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 acute jaundice and how to avoid them

Spyridon Siakavellas, Georgios Papatheodoridis

Summary

AI Generated

Jaundice arises from abnormalities in bilirubin formation, metabolism, or excretion, or from biliary tree obstruction at any anatomical level, and numerous conditions can cause it.

Jaundice can result from abnormalities in bilirubin formation, metabolism, and excretion processes
Obstruction of the biliary tree from intrahepatic origins to the ampulla of Vater can cause jaundice even when bilirubin processing is functioning properly
The material presents the view that a careful diagnostic approach is warranted to identify the underlying cause
The material states that prompt intervention saves lives in many cases, contrasting with conventional wisdom that jaundice by itself never killed anyone

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.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Fevery J. Bilirubin in clinical practice: a review. Liver Int 2008; 28: 592–605. [Link]

Silverberg NB and Lee-Wong M. Generalized yellow discoloration of the skin. The diagnosis: carotenemia. Cutis 2014; 93: E11–E12. [Link]

Erlinger S, Arias IM and Dhumeaux D. Inherited disorders of bilirubin transport and conjugation: new insights into molecular mechanisms and consequences. Gastroenterology 2014; 146: 1625–1638. [Link]

Marchand A, Galen RS and Van Lente F. The predictive value of serum haptoglobin in hemolytic disease. JAMA 1980; 243: 1909–1911. [Link]

Vitek L, et al. Gilbert syndrome and ischemic heart disease: a protective effect of elevated bilirubin levels. Atherosclerosis 2002; 160: 449–456. [Link]

European Association for the Study of the Liver. EASL Clinical Practical Guidelines on the management of acute (fulminant) liver failure. J Hepatol 2017; 66: 1047–1081. [Link]

Taylor T and Wheatley M. Jaundice in the emergency department: meeting the challenges of diagnosis and treatment. Emerg Med Pract 2018; 20: 1–24. [Link]

Vuppalanchi R, Liangpunsakul S and Chalasani N. Etiology of new-onset jaundice: how often is it caused by idiosyncratic drug-induced liver injury in the United States? Am J Gastroenterol 2007; 102: 558–562. [Link]

European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Autoimmune hepatitis. J Hepatol 2015; 63: 971–1004. [Link]

10.

Chand N and Sanyal AJ. Sepsis-induced cholestasis. Hepatology 2007; 45: 230–241. [Link]

11.

Giallourakis CC, Rosenberg PM and Friedman LS. The liver in heart failure. Clinics Liv Dis 2002; 6: 947–967. [Link]

12.

van Lingen R, et al. Jaundice as a presentation of heart failure. J R Soc Med 2005; 98: 357–359. [Link]

13.

Okwara CJ, et al. Jaundice: A thyroid problem? Dig Dis Sci 2017; 62: 1901–1905. [Link]

14.

Saik RP, et al. Spectrum of cholangitis. Am J Surg 1975; 130: 143–150. [Link]

15.

Miura F, et al. TG13 flowchart for the management of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci 2013; 20: 47–54. [Link]

16.

Thursz MR, et al. Prednisolone or pentoxifylline for alcoholic hepatitis. New Engl J Med 2015; 372: 1619–1628. [Link]

17.

Crabb DW, et al. Standard definitions and common data elements for clinical trials in patients with alcoholic hepatitis: Recommendation From the NIAAA Alcoholic Hepatitis Consortia. Gastroenterology 2016; 150: 785–790. [Link]

18.

Moreau R, et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology 2013; 144: 1426–1437, e1–9. [Link]

19.

Desmet VJ, et al. Classification of chronic hepatitis: diagnosis, grading and staging. Hepatology 1994; 19: 1513–1520. [Link]

20.

Kamath PS, et al. A model to predict survival in patients with end-stage liver disease. Hepatology 2001; 33: 464–470. [Link]

Abstract

Jaundice can be caused by abnormalities in any of the steps comprising the formation, metabolism and excretion of bilirubin. In addition, these processes may be functioning properly, but jaundice can be seen because of an obstruction of the biliary tree at any point, from its intrahepatic origins to its end at the ampulla of Vater. For this reason, it is clear that numerous conditions can result in jaundice. When faced with a patient presenting with jaundice a reasonable and careful diagnostic approach is, therefore, warranted to elucidate the underlying cause of this sign. Conventional wisdom may be that “jaundice by itself never killed anyone,” but it is imperative to find the cause as soon as possible, as prompt intervention saves lives in many cases.

Topics

Hepatobiliary

Citation

Siakavellas S and Papatheodoridis G. Mistakes in acute jaundice and how to avoid them. UEG Education 2018; 18: 24–26.

Published

2025

More Like This:

Coeliac disease with David Sanders

Pradeep Mundre

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

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

The European Multidisciplinary Evidence-Based Guideline on Pancreatic Cancer: Methodological Protocol

Laura Leeuwenburgh

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.

Coeliac disease with David Sanders

David S. Sanders, Pradeep Mundre

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Topics

Small Intestine & Nutrition

Published

2026

More Like This:

Coeliac disease with David Sanders

Pradeep Mundre

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

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

The European Multidisciplinary Evidence-Based Guideline on Pancreatic Cancer: Methodological Protocol

Laura Leeuwenburgh

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:

Coeliac disease with David Sanders

Pradeep Mundre

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

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

The European Multidisciplinary Evidence-Based Guideline on Pancreatic Cancer: Methodological Protocol

Laura Leeuwenburgh

UEG Standards and Guidelines

Clinical Practice Guideline

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 Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Guideline

ABSTRACT

Pain is often the presenting symptom of acute pancreatitis (AP) and has a prognostic significance, with poorly treated pain affecting patient outcomes. Despite this, there are currently no international recommendations for pain management in patients admitted with AP. This current guideline was developed following the United European Gastroenterology framework for the development of high-quality clinical guidelines. Nine working groups were formed to develop statements on pain management in AP from admission to discharge. After systematic literature reviews, the evidence was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation methodology, as appropriate. Statements and comments were developed by the working groups and voted using three rounds of Delphi method. The guidelines concluded that acute postoperative pain management guidelines are applicable for treating acute pain due to AP. The numerical rating scale is preferred for pain assessment because of better compliance. Opioids currently form the cornerstone of severe pain management. Potent opioids such as buprenorphine and pentazocine provide superior pain relief over non-opioid medications and decrease the need for rescue analgesia. Current evidence does not consistently demonstrate harm from opioids in AP. In patients with severe pain, safety concerns should not delay the timely use of opioids to ensure adequate pain management. Specific recommendations concerning the use of epidural analgesia, acupuncture and management of pain in the paediatric population and during pregnancy are provided based on evidence and expert opinions. Finally, the unmet needs for future research were discussed and proposed.

Guideline

Clinical Practice Guideline

Topics

Pancreas

Citation

United European Gastroenterology Journal, 2026

Published

2026

More Like This:

Coeliac disease with David Sanders

Pradeep Mundre

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

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

The European Multidisciplinary Evidence-Based Guideline on Pancreatic Cancer: Methodological Protocol

Laura Leeuwenburgh

UEG Mistakes In Articles

New

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 hepatocellular carcinoma and how to avoid them

Spyridon Pantzios, Ioannis Elefsiniotis, Christos Triantos

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Fevery J. Bilirubin in clinical practice: a review. Liver Int 2008; 28: 592–605. [Link]

Silverberg NB and Lee-Wong M. Generalized yellow discoloration of the skin. The diagnosis: carotenemia. Cutis 2014; 93: E11–E12. [Link]

Marchand A, Galen RS and Van Lente F. The predictive value of serum haptoglobin in hemolytic disease. JAMA 1980; 243: 1909–1911. [Link]

Vitek L, et al. Gilbert syndrome and ischemic heart disease: a protective effect of elevated bilirubin levels. Atherosclerosis 2002; 160: 449–456. [Link]

European Association for the Study of the Liver. EASL Clinical Practical Guidelines on the management of acute (fulminant) liver failure. J Hepatol 2017; 66: 1047–1081. [Link]

Taylor T and Wheatley M. Jaundice in the emergency department: meeting the challenges of diagnosis and treatment. Emerg Med Pract 2018; 20: 1–24. [Link]

European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Autoimmune hepatitis. J Hepatol 2015; 63: 971–1004. [Link]

10.

Chand N and Sanyal AJ. Sepsis-induced cholestasis. Hepatology 2007; 45: 230–241. [Link]

11.

Giallourakis CC, Rosenberg PM and Friedman LS. The liver in heart failure. Clinics Liv Dis 2002; 6: 947–967. [Link]

12.

van Lingen R, et al. Jaundice as a presentation of heart failure. J R Soc Med 2005; 98: 357–359. [Link]

13.

Okwara CJ, et al. Jaundice: A thyroid problem? Dig Dis Sci 2017; 62: 1901–1905. [Link]

14.

Saik RP, et al. Spectrum of cholangitis. Am J Surg 1975; 130: 143–150. [Link]

15.

Miura F, et al. TG13 flowchart for the management of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci 2013; 20: 47–54. [Link]

16.

Thursz MR, et al. Prednisolone or pentoxifylline for alcoholic hepatitis. New Engl J Med 2015; 372: 1619–1628. [Link]

17.

18.

Moreau R, et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology 2013; 144: 1426–1437, e1–9. [Link]

19.

Desmet VJ, et al. Classification of chronic hepatitis: diagnosis, grading and staging. Hepatology 1994; 19: 1513–1520. [Link]

20.

Kamath PS, et al. A model to predict survival in patients with end-stage liver disease. Hepatology 2001; 33: 464–470. [Link]

Abstract

Liver cancer is the sixth most common cancer and the third leading cause of cancer-related death. Hepatocellular carcinoma (HCC) accounts for about 90% of cases and mostly arises in chronic liver disease, especially cirrhosis. Viral hepatitis remains a leading cause, but alcohol-related disease and MASLD are rising. With immune checkpoint inhibitors transforming HCC management, it is timely to highlight common mistakes across screening, staging, diagnosis and treatment.

Topics

Digestive Oncology Hepatobiliary

Published

2026

More Like This:

Coeliac disease with David Sanders

Pradeep Mundre

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

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

The European Multidisciplinary Evidence-Based Guideline on Pancreatic Cancer: Methodological Protocol

Laura Leeuwenburgh

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 Pancreatic exocrine insufficiency and how to avoid them

Miroslav Vujasinovic, J. Enrique Domínguez Muñoz, Matthias Löhr

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Fevery J. Bilirubin in clinical practice: a review. Liver Int 2008; 28: 592–605. [Link]

Silverberg NB and Lee-Wong M. Generalized yellow discoloration of the skin. The diagnosis: carotenemia. Cutis 2014; 93: E11–E12. [Link]

Marchand A, Galen RS and Van Lente F. The predictive value of serum haptoglobin in hemolytic disease. JAMA 1980; 243: 1909–1911. [Link]

Vitek L, et al. Gilbert syndrome and ischemic heart disease: a protective effect of elevated bilirubin levels. Atherosclerosis 2002; 160: 449–456. [Link]

European Association for the Study of the Liver. EASL Clinical Practical Guidelines on the management of acute (fulminant) liver failure. J Hepatol 2017; 66: 1047–1081. [Link]

Taylor T and Wheatley M. Jaundice in the emergency department: meeting the challenges of diagnosis and treatment. Emerg Med Pract 2018; 20: 1–24. [Link]

European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Autoimmune hepatitis. J Hepatol 2015; 63: 971–1004. [Link]

10.

Chand N and Sanyal AJ. Sepsis-induced cholestasis. Hepatology 2007; 45: 230–241. [Link]

11.

Giallourakis CC, Rosenberg PM and Friedman LS. The liver in heart failure. Clinics Liv Dis 2002; 6: 947–967. [Link]

12.

van Lingen R, et al. Jaundice as a presentation of heart failure. J R Soc Med 2005; 98: 357–359. [Link]

13.

Okwara CJ, et al. Jaundice: A thyroid problem? Dig Dis Sci 2017; 62: 1901–1905. [Link]

14.

Saik RP, et al. Spectrum of cholangitis. Am J Surg 1975; 130: 143–150. [Link]

15.

Miura F, et al. TG13 flowchart for the management of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci 2013; 20: 47–54. [Link]

16.

Thursz MR, et al. Prednisolone or pentoxifylline for alcoholic hepatitis. New Engl J Med 2015; 372: 1619–1628. [Link]

17.

18.

Moreau R, et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology 2013; 144: 1426–1437, e1–9. [Link]

19.

Desmet VJ, et al. Classification of chronic hepatitis: diagnosis, grading and staging. Hepatology 1994; 19: 1513–1520. [Link]

20.

Kamath PS, et al. A model to predict survival in patients with end-stage liver disease. Hepatology 2001; 33: 464–470. [Link]

Abstract

Pancreatic exocrine insufficiency (PEI) is a common yet frequently under-recognised cause of maldigestion, malabsorption, and malnutrition. Although traditionally associated with primary pancreatic disorders such as chronic pancreatitis, cystic fibrosis, pancreatic cancer, or pancreatic surgery, it is now evident that PEI also occurs in a wide range of extra-pancreatic conditions and clinical settings. Advances in diagnostic testing and expanding clinical awareness have improved detection; however, significant misconceptions persist regarding when to suspect PEI; how to interpret diagnostic tests; and how to initiate, optimise, and monitor pancreatic enzyme replacement therapy (PERT). In everyday practice, these errors may lead to delayed diagnosis, inappropriate treatment, persistent symptoms, and preventable nutritional deficiencies. This “Mistakes in…” article highlights common pitfalls in the diagnosis and management of PEI, focusing on inappropriate reliance on faecal elastase testing, failure to recognise secondary causes, undertreatment with PERT, and inadequate nutritional assessment. By addressing these frequent mistakes, we aim to promote a more structured, patient-centred, and evidence-informed approach to PEI that improves clinical outcomes and quality of life.

Topics

Pancreas

Published

2026

More Like This:

Coeliac disease with David Sanders

Pradeep Mundre

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

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

The European Multidisciplinary Evidence-Based Guideline on Pancreatic Cancer: Methodological Protocol

Laura Leeuwenburgh

UEG Standards and Guidelines

Clinical Practice Guideline

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.

The European Multidisciplinary Evidence-Based Guideline on Pancreatic Cancer: Methodological Protocol

Laura Leeuwenburgh

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Guideline

ABSTRACT

Background

Pancreatic cancer remains one of the most lethal cancers despite extensive efforts and research conducted over the past decades. To effectuate groundbreaking improvements in pancreatic cancer treatment, interdisciplinary and international collaboration is essential. Evidence-based guidelines, including state-of-the-art evidence and expert opinion, are crucial to guide medical specialists, researchers, and patients, especially on issues where consensus is still lacking. This article describes the methodological protocol for the development of the European Multidisciplinary Evidence-Based Guideline on Pancreatic Cancer. The guideline aims to identify current knowledge gaps on pancreatic cancer management, develop questions based on these knowledge gaps, and answer these questions with evidence-based recommendations supplemented, when evidence is lacking, with expert advice for treatment and future research.

Methods

This guideline development protocol is developed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The process is structured into six stages: First, 13 theme-based multidisciplinary working groups are established, comprising representatives from 30 European medical and patient societies. Second, these working groups identify the most relevant current knowledge gaps on pancreatic cancer within their theme and formulate key questions. Third, the available evidence to answer these key questions is obtained through systematic reviews and the certainty of evidence is assessed using the GRADE approach. Fourth, recommendations are developed based on the available evidence. Fifth, all participants reach consensus on the recommendations through a modified Delphi process. Sixth, the recommendations are discussed during an open conference, including an external validation committee.

Discussion

This methodological protocol of the European Multidisciplinary Evidence-Based Guideline on Pancreatic Cancer is designed to identify key knowledge gaps across 13 themes and formulate evidence-based recommendations. This guideline initiative unites 30 European medical and patient societies for pancreatic cancer.

Summary

Methodological protocol of an international multi-disciplinary guideline involving 30 European medical and patient societies.
This protocol highlights the six stages of the guideline development process, adhering to the key principles of the GRADE methodology, and thereby aims to maximise transparency and methodological quality.
With addressing knowledge gaps, this guideline will uncover areas with limited evidence. A priority rating for research needs, based on a survey, will be established, highlighting areas where future research is most warranted.

Guideline

Clinical Practice Guideline

Topics

Pancreas

Citation

Clinical and Public Health Guidelines 3 (2026)

Published

2026

More Like This:

Coeliac disease with David Sanders

Pradeep Mundre

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

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Mistakes in Pancreatic exocrine insufficiency and how to avoid them

Matthias Löhr

The European Multidisciplinary Evidence-Based Guideline on Pancreatic Cancer: Methodological Protocol

Laura Leeuwenburgh