Initial Management of Acute Pancreatitis

In patients with AP, the AGA suggests using goal-directed therapy for fluid management. Note that the AGA makes no recommendation whether normal saline or Ringer’s lactate is used.

In patients with AP, the AGA suggests against the use of hydroxyethyl starch (HES) fluids.

In patients with AP, the AGA recommends early (within 24 h) oral feeding as tolerated, rather than keeping the patient nil per os (npo).

In patients with AP and inability to feed orally, the AGA recommends enteral rather than parenteral nutrition.

In patients with predicted severe AP and necrotizing AP, the AGA suggests against the use of prophylactic antibiotics.

In patients with predicted severe or necrotizing pancreatitis requiring enteral tube feeding, the AGA suggest either NG or NJ route.

In patients with acute biliary pancreatitis, the AGA recommends cholecystectomy during the initial admission rather than after discharge.

In patients with acute biliary pancreatitis and no cholangitis, the AGA suggests against the routine use of urgent ERCP.

In patients with acute alcoholic pancreatitis, the AGA recommends brief alcohol intervention during admission.