coMpliAnce with evideNce-based cliniCal guidelines in the managemenT of acute biliaRy pancreAtitis): The MANCTRA-1 international audit

• Published in: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2022-11, Vol.22 (7), p.902-916
• Main Authors: Di Saverio, Salomone, Damaskos, Dimitrios, Agnoletti, Vanni, Kluger, Yoram, Pisanu, Adolfo, di Saverio, Salomone, Pellino, Gianluca, Leppaniemi, Ari, Poillucci, Gaetano, Ferrario, Luca, Wilson, Michael, Ioannidis, Argyrios, De Simone, Belinda, Khamees, Almu'atasim, Mohamad, Ikhwan Sani, Yusoff, Ahmad Ramzi, Elshami, Mohamedraed, Alawadhi, Kamel, Ralon, Sergio, Isik, Arda, Guerrieri, Mario, Sartori, Alberto, Awad, Ahmed, Sherief-Ghozy, Abdelsalam, Wafaa, Elfallal, Ahmed, Shetiwy, Mohamed, Hamed, Emad Fawzi, Chouillard, Elie, Ioannidis, Orestis, Papadoliopoulou, Maria, Petrakis, George, Chouliaras, Christos, Theodorou, Dimitrios, Syllaios, Athanasios, Machairas, Nikolaos, Kykalos, Stylianos, Kalaitzakis, Evangelos, Gupta, Amit, Bains, Lovenish, Lal, Pawan, Magnoli, Matteo, Serventi, Alberto, Di Lascio, Pierpaolo, Cicako, Atea, Morino, Mario, Pignata, Giusto, Murzi, Valentina, Bianchi, Valentina, Fontana, Tommaso, Sarro, Giuliano, Scaravilli, Luca, Papa, Mario Virgilio, Licitra, Edelweiss, Savino, Grazia, Porfidia, Raffaele, Marra, Ester, Frontali, Alice, Favi, Francesco, Rampini, Alessia, Calì, Matteo, Papa, Gennaro, Prioriello, Concetta, Bono, Dario, Salomone, Sara, Chirletti, Piero, Veroux, Massimiliano, Ammendola, Michele, Perotti, Bruno, Awadi, Sajeda, Naief Naffa', Mo'taz Fawzat, Sawalha, Hatem, Ahmed Fathil, Ida Nadiah, Zakaria, Andee Dzulkarnaen, Beristain-Hernandez, Jose-Luis, Condoy, Jefferson Nieves, Ordemar, Jorge, Noel, Colin, Álvarez Morán, Laura, Feijóo, Eva Pont, Di Martino, Marcello, Perez de Villar, José Manuel, Sánchez-Guillén, Luis, Caravaca, Iban, Ramírez, Pablo, Atici, Semra Demirli, Khan, Mansoor, Bradley, Alison, Beasley, Daniel, Prasanti, Alekhya Kotta, Gaber, Mohannad, Zafar, Noman, Lezama, Tamara, Doulias, Triantafyllos, Cal, Fernando Bonilla, Sánchez, Lianet
• Format: Article
• Language: English
• Subjects: Acute Disease; Acute pancreatitis; Antibiotics; Biliary pancreatitis; Cholecystectomy; Clinical practice guidelines; Compliance; Computed tomography; Cysts; Departments; Enteral feeding; Enteral Nutrition; Epidemiology; Gastroenterology; Global surgery; Guidelines compliance; Hospitalization; Hospitals; Humans; International audit; Kruskal-Wallis test; Mortality; Pancreatitis; Pancreatitis - diagnosis; Pancreatitis - surgery; Patients; Regression analysis; Surgery
• ISSN: 1424-3903; 1424-3911
• DOI: 10.1016/j.pan.2022.07.007

Reports about the implementation of recommendations from acute pancreatitis guidelines are scant. This study aimed to evaluate, on a patient-data basis, the contemporary practice patterns of management of biliary acute pancreatitis and to compare these practices with the recommendations by the most updated guidelines. All consecutive patients admitted to any of the 150 participating general surgery (GS), hepatopancreatobiliary surgery (HPB), internal medicine (IM) and gastroenterology (GA) departments with a diagnosis of biliary acute pancreatitis between 01/01/2019 and 31/12/2020 were included in the study. Categorical data were reported as percentages representing the proportion of all study patients or different and well-defined cohorts for each variable. Continuous data were expressed as mean and standard deviation. Differences between the compliance obtained in the four different subgroups were compared using the Mann-Whitney U, Student's t, ANOVA or Kruskal-Wallis tests for continuous data, and the Chi-square test or the Fisher's exact test for categorical data. Complete data were available for 5275 patients. The most commonly discordant gaps between daily clinical practice and recommendations included the optimal timing for the index CT scan (6.1%, χ2 6.71, P = 0.081), use of prophylactic antibiotics (44.2%, χ2 221.05, P