A prospective multicentre survey on the treatment of acute pancreatitis in Italy

Dig Liver Dis. 2007 Sep;39(9):838-46. doi: 10.1016/j.dld.2007.05.014. Epub 2007 Jun 29.


Background: The Italian Association for the Study of the Pancreas released a diagnostic and therapeutic algorithm for acute pancreatitis in 1999.

Aim: This study focused on the analysis of the therapeutic approach for the treatment of acute pancreatitis in Italy.

Patients: One thousand, one hundred and seventy-three patients were recruited: 1006 patients (85.8%) had mild acute pancreatitis (MAP) and 167 (14.2%) had the severe acute pancreatitis (SAP); 161 patients showed pancreatic necrosis at computed tomography; 121 patients (10.3%) had sequelae and 36 (3.1%) died.

Results: Non-steroidal anti-inflammatory drugs and tramadol were used more frequently in patients with the MAP whereas opioids and the association schedules were used more frequently in patients with the SAP (P<0.001). Gabexate mesilate was utilised in 831 out of 1173 patients (70.8%); in particular, gabexate mesilate was used in 70.6% patients with MAP and in 73.1% of those with SAP (P=0.521). The duration of the drug administration was significantly shorter in those having MAP than in those having the SAP (P<0.001). The antibiotics most frequently used for the prophylaxis against infection from pancreatic necrosis (43.1%) were carbapenems. Only a small number of patients received enteral nutrition (4.7%). Endoscopic retrograde cholangiopancreatography was carried out in 344 of the 1173 patients (29.3%). Surgery was performed in 48 with SAP (19 had elective biliary surgery and 29 had pancreatic surgery).

Conclusions: The results of this survey indicate a lack of compliance with the guidelines which regard the indications mainly for interventional endoscopy and surgery.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analgesics / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Digestive System Surgical Procedures / statistics & numerical data
  • Female
  • Histamine Antagonists / therapeutic use
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Pancreatitis / drug therapy*
  • Pancreatitis / epidemiology
  • Pancreatitis / surgery*
  • Prospective Studies
  • Severity of Illness Index
  • Treatment Outcome


  • Analgesics
  • Anti-Bacterial Agents
  • Histamine Antagonists