Revised JPN guidelines for the management of acute pancreatitis: JPN guidelines 2015

Revised JPN guidelines for the management of acute pancreatitis: JPN guidelines 2015 Toshihiko Mayumi, Tadahiro Takada, Masamichi Yokoe, Masahiro Yoshida University of Occupational and Environmental Health, Japan Teikyo University School of Medicine, Japan Japanese Red Cross Nagoya Daini Hospital, Japan Clinical Research Center Kaken Hospital, International University of Health and Welfare, Japan Background/Purpose: JPN guidelines for the management of acute pancreatitis were published in 2003 and revised in 2007 and 2009 that the severity assessment score has been highly regarded all over the world. Since the classification and the definition of acute pancreatitis had been changed significantly in the New Atlanta classification of acute pancreatitis 2012, the working group of JPN guidelines revised JPN guidelines with making new meta-analysis and using the GRADE system. Methods: The working group of revising JPN guidelines consists of 28 specialists, surgeons, gastroenterologists, endoscopists, radiologists, and epidemiologists. Results: JPNguidelines 2015 containmajor topics as described below: (1) epidemiology and etiology, (2) diagnostic criteria, (3) severity scoring system, (4) fundamental and intensive care with flowcharts, (5) therapeutic intervention and surgery, (6) post-ERCP pancreatitis, (7) treatment strategy, (8) clinical indicator andpancreatitis bundles, and (9) imaging. JPN guidelines also released mobile applications for the management of acute pancreatitis. Meta-analyses were performed on prophylactic antibiotic use for the prevention of necrotizing pancreatitis and reduction of mortality and on prophylactic pancreatic stent placement for the prevention of post-ERCP pancreatitis. These metaanalysis data have the results that significant effects are expected to each setting. JPN guidelines 2015 take advantage of this brand-new evidence for the new idea for the treatment of acute pancreatitis. Conclusions: Revised JPN guidelines 2015 achieve further evolution with new meta-analysis data and contain a lot of recommendations using the GRADE system for clinical use.