Abstract
We reviewed the revised process of the JPN Guidelines for acute pancreatitis (AP) with a specific focus on the items at diagnosis, severity assessment, and the criterion for transfer. The diagnostic criteria for acute pancreatitis were revised by the Research Group for Intractable Diseases and Refractory Pancreatic Diseases, Japanese Ministry of Health, Labour and Welfare (JMHLW Criteria). Blood amylase was initially recommended in the laboratory examination, and subsequently blood lipase is now the first step for diagnosing AP. The revised criteria for severity assessment of AP consist of nine poor prognostic factors and the computed tomography (CT) grades based on contrast-enhanced CT. The new criteria assess the severity of AP as mild to severe. The criterion for transfer was a score of 2 or more of previous severity assessment criteria, and was revised to those of 3 or more of existing criteria. It is desirable to transfer patients with severe AP to a medical institution where full-time physicians exist who are specialized in intensive care, endoscopic treatment, radiological intervention, and staffed by cholangiopancreatic surgeons.
