Revisions in the 2015 Japanese guidelines for the management of acute pancreatitis: 1. Medical treatments

Abstract

With regards to Medical Treatment in the Japanese (JPN) guidelines for the management of acute pancreatitis, clinical questions (CQ) were set in the field of pain control, antibiotics prophylaxis, anti-fungus prophylaxis, and protease inhibitor or administration of histamine H2 receptor blocker. In this article, we describe revisions made in the JPN guidelines 2015 with regards to these items from the 2010 version. Many recent reports have shown that the prophylactic administration of antibiotics used for acute pancreatitis is not effective. In the JPN guidelines 2015, the Meta-analysis team of the guideline committee performed their own analysis and proposed new recommendations dependent on the results from antibiotics prophylaxis. The efficacy of continuous high-dose intravenous administration of protease inhibitor for severe acute pancreatitis should be discussed through large scaled, high quality RCTs.