Variations in implementation of current national guidelines for the treatment of acute pancreatitis: implications for acute surgical service provision

Objectives: The aim of this study was to explore the implementation of the current national guidelines for the treatment of acute pancreatitis. By taking pooled data from all available individual and regional audits, the study aimed to identify areas of consistent variance from the 'best practice' stipulated in the guidelines. Methods: All published audits of the management of acute pancreatitis where treatment was compared to the current British Society of Gastroenterology guidelines for the treatment of acute pancreatitis were identified from a search of MEDLINE and the published abstracts of relevant specialty meetings. Results: Five audits providing pooled data on 545 patients were identified. Overall mortality from severe disease was 8% (range, 4-17%). Definitive treatment of gallstone disease within 4 weeks of index attack was performed in 49% (range, 16-63%). High dependency or intensive care facilities for severe disease were available in 52% (range, 20-100%). Conclusion: This study demonstrates the presence of striking variations in the implementation of the current national guidelines for the treatment of acute pancreatitis.