UK guidelines for management of acute pancreatitis: is it time to change?

The incidence of acute pancreatitis is increasing in the UK,1 with a current hospital admission rate of 9.8 per year per 100 000 population.1 However, there has only been a marginal decrease in the overall one year case fatality rate, from 12.7% in 1975–86 to 11.8% in 1987–98.1 Gall stones and alcohol are the main aetiological factors for acute pancreatitis.2 Nearly 25% of episodes of acute pancreatitis are severe3 and approximately 45% of these are due to gall stones.2 The UK guidelines for the management of acute pancreatitis were formulated and released by the British Society of Gastroenterology (BSG) in 1998.4 MEDLINE, EMBASE, and the Cochrane databases were searched to find recent evidence in the management of acute pancreatitis. …