Abstract
The majority of patients with acute pancreatitis have a mild form of the disease that has a very low mortality rate and resolves spontaneously. All patients with acute pancreatitis may require hospitalization, and pancreatic rest with fasting, pain control, aggressive fl uid replacement, and monitoring of hemodynamic and respiratory status being essential. This article provides a brief update on the Japanese Guidelines for the Management of Acute Pancreatitis and describes details of recent advances in three important aspects of management;prophylactic antibiotics, protease inhibitors, and nutrition support. Total enteral nutrition, when compared with total parenteral nutrition, has been shown to have benefits in patients with severe acute pancreatitis but not with mild acute pancreatitis. There is no evidence that prophylactic antibiotics in mild acute pancreatitis improves patient outcomes. Oral refeeding can be started when pain is controlled and the pancreatic enzymes return to normalcy. Unfortunately, not enough information is available on oral refeeding after acute pancreatitis and more research is needed to clarify the optimal timing of oral refeeding and the optimal form of diet after acute pancreatitis.
