Management of acute pancreatitis in clinical practice

Over the last few years, remarkable progress has been made in diagnosis, se verity assessment and treatment as well as in our understanding of the path ophysiology of acute pancreatitis. New treatment modalities and new specifi c drugs have been introduced and this has led to practical changes in the d aily bedside management of patients with acute pancreatitis. Treatment is e ssentially medical, both for mild and severe disease, and is aimed at reduc ing abdominal pain, restoring electrolyte and fluid losses, removing the ae tiological factor(s), attenuating inflammation and autodigestive processes, as well as preventing local and systemic complications. Diagnostic and int erventional percutaneous or endoscopic procedures are indicated mainly for patients with severe forms of the disease. Surgery is generally indicated f or patients with necrosis infection or other local complications not manage able by percutaneous or endoscopic means.