개정된 대한췌장담도학회 급성췌장염 임상진료지침: 초기 치료, 영양지원, 회복기 치료

Abstract

Initial and convalescent treatment of acute pancreatitis (AP) is important in order to improve the prognosis and prevent the recurrence in the patients with AP. Initial intensive treatment includes fluid therapy, pain control, antimicrobial therapy, endoscopic retrograde cholangiopancreatography (ERCP), and nutritional support. Goal-directed therapy is recommended for fluid therapy, and the routine use of prophylactic antibiotics is not recommended. In acute gallstone pancreatitis, urgent ERCP should be performed only in patients with cholangitis or persistent cholestasis. Early oral feeding is advisable as tolerated and enteral feeding via nasogastric or nasojejunal tube appear comparable. In convalescent treatment, cholecystectomy during the initial admission is advisable for mild biliary pancreatitis with gallstone as possible, and treatment against alcohol dependence is considerable for recurrent acute alcoholic pancreatitis. In this review, we recommend practice guidelines for initial treatment, nutritional support, and convalescent treatment.