AEG‐AESPANC‐OPGE‐SIED‐SPG Ibero‐Latin American Guidelines on Acute Pancreatitis (iLATAM‐AP)

INTRODUCTION: Acute pancreatitis (AP) is a major cause of gastrointestinal hospitalizations worldwide. Although typically self-limiting, up to one-third of cases develop complications associated with increased morbidity and mortality. Despite recent advances that have improved outcomes, clinical heterogeneity necessitates updated, evidence-based guidance. In addition, there remains a need to improve the implementation of evidence-based recommendations across Ibero-Latin American countries by bringing together diverse scientific societies and regional experts to enhance applicability and the dissemination of best practices. This guideline offers comprehensive recommendations for both mild and complicated AP diagnosis and management. METHODS: Questions on AP management were addressed by expert teams comprising one coordinator and four pancreatology specialists from the Iberian Peninsula and Latin America. For each question, a systematic review was conducted using PubMed, Embase, and the Cochrane Library, focusing on randomized controlled trials and systematic reviews published between January 1979 and March 2024 in English, Spanish, or Portuguese. In the absence of high-quality evidence, the search was expanded to include observational studies. Recommendations were formulated using the GRADE system and submitted to an expert panel for consensus; unresolved questions were revised and resubmitted until consensus was reached. RESULTS: Twenty evidence-based recommendations were developed, addressing key aspects of AP management, including definitions, diagnostic criteria, etiological assessment, initial management, management of local complications, splanchnic vein thrombosis, abdominal compartment syndrome, indications for intensive care admission, antibiotic use, early endoscopic retrograde cholangiopancreatography, timing of cholecystectomy, strategies for detecting choledocholithiasis, and the management of pancreatic function insufficiency. Each recommendation included a statement, the level of evidence, the strength of the recommendation, and a summary of the supporting evidence. CONCLUSION: The iLATAM guidelines are the first Ibero-Latin American clinical practice guidelines for AP. They provide evidence-based recommendations integrating medical, endoscopic, and surgical approaches, with the aim of promoting consistent, high-quality care across diverse healthcare settings. TRAIL REGISTRATION: In alignment with international standards for transparency and methodological rigor, the methodological protocol for this guideline was registered in PROSPERO (International Prospective Register of Systematic Reviews) on July 23, 2022 (Registration ID: CRD42022345788).

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Journal
United European Gastroenterology Journal
Published
2026-05-30
DOI
https://doi.org/10.1002/ueg2.70190
Primary Topic
Pancreatitis Pathology and Treatment
Type
article
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article

AEG‐AESPANC‐OPGE‐SIED‐SPG Ibero‐Latin American Guidelines on Acute Pancreatitis (iLATAM‐AP)

William Manzanares, José Joaquín Mira-Solves, Lucía Guilabert, Jose A. Gonzalez et al.
United European Gastroenterology Journal
Pancreatitis Pathology and Treatment
article

AEG‐AESPANC‐OPGE‐SIED‐SPG Ibero‐Latin American Guidelines on Acute Pancreatitis (iLATAM‐AP)

William Manzanares, José Joaquín Mira-Solves, Lucía Guilabert, Jose A. Gonzalez, Fabio Ausania, Pedro Moutinho-Ribeiro, Irene Carrillo, Andreia Rei, Natalia Corzo-Zamora, Carla Mancilla, Ana García García de Paredes, Sandra Basso, N Rodríguez-Ferreiro, Bruno Rosa, Adriana Cowdin, Eva Marín-Serrano, María Francisco, B. Valero, Susana Marques, Antonio López-Serrano, Mario Pelaez-Luna, Alejandro Piscoya, Claudia Sánchez-Marin, Alberto Espino, Miguel Bispo, Karina Cárdenas‐Jaén, Guido Villagómez, Isabel Pascual‐Moreno, Alexandra Fernandes, Eduardo Rodrigues‐Pinto, João Lopes‐Delgado, Rómulo D. Vargas, Fauze Maluf‐Filho, Enrique de‐Madaria, Ricardo Rio‐Tinto, Susana Lopes, Emma Martínez‐Moneo, Neftalí Jara Pérez‐López, José M. Ramia, Edson Guzmán‐Calderon, Humberto Cristino, Daniel de la Iglesia, Lucas Granero, Zoltán Berger, Rodrigo Mansilla
article en

Abstract

INTRODUCTION: Acute pancreatitis (AP) is a major cause of gastrointestinal hospitalizations worldwide. Although typically self-limiting, up to one-third of cases develop complications associated with increased morbidity and mortality. Despite recent advances that have improved outcomes, clinical heterogeneity necessitates updated, evidence-based guidance. In addition, there remains a need to improve the implementation of evidence-based recommendations across Ibero-Latin American countries by bringing together diverse scientific societies and regional experts to enhance applicability and the dissemination of best practices. This guideline offers comprehensive recommendations for both mild and complicated AP diagnosis and management. METHODS: Questions on AP management were addressed by expert teams comprising one coordinator and four pancreatology specialists from the Iberian Peninsula and Latin America. For each question, a systematic review was conducted using PubMed, Embase, and the Cochrane Library, focusing on randomized controlled trials and systematic reviews published between January 1979 and March 2024 in English, Spanish, or Portuguese. In the absence of high-quality evidence, the search was expanded to include observational studies. Recommendations were formulated using the GRADE system and submitted to an expert panel for consensus; unresolved questions were revised and resubmitted until consensus was reached. RESULTS: Twenty evidence-based recommendations were developed, addressing key aspects of AP management, including definitions, diagnostic criteria, etiological assessment, initial management, management of local complications, splanchnic vein thrombosis, abdominal compartment syndrome, indications for intensive care admission, antibiotic use, early endoscopic retrograde cholangiopancreatography, timing of cholecystectomy, strategies for detecting choledocholithiasis, and the management of pancreatic function insufficiency. Each recommendation included a statement, the level of evidence, the strength of the recommendation, and a summary of the supporting evidence. CONCLUSION: The iLATAM guidelines are the first Ibero-Latin American clinical practice guidelines for AP. They provide evidence-based recommendations integrating medical, endoscopic, and surgical approaches, with the aim of promoting consistent, high-quality care across diverse healthcare settings. TRAIL REGISTRATION: In alignment with international standards for transparency and methodological rigor, the methodological protocol for this guideline was registered in PROSPERO (International Prospective Register of Systematic Reviews) on July 23, 2022 (Registration ID: CRD42022345788).

United European Gastroenterology JournalVol. 14(5)
Universitat de Miguel Hernández d'Elx (ES), Champalimaud Foundation (PT), Peruvian University of Applied Sciences (PE), Universitat de València (ES), Pontificia Universidad Católica de Chile (CL), Universidad Autónoma de Nuevo León (MX), Instituto Politécnico de Leiria (PT), Instituto Cajal (ES), Hospital Universitario La Paz (ES), Instituto de Salud Carlos III (ES), Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (ES), Hospital de São João (PT), San Sebastián University (CL), Hospital Clínico Universitario de Valencia (ES), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (MX), Hospital da Senhora da Oliveira Guimarães (PT), Marqués de Valdecilla University Hospital (ES), Instituto Boliviano de Ciencia y Tecnología Nuclear (BO), Hospital Universitario Puerta de Hierro Majadahonda (ES), Anglo American (United Kingdom) (GB), Instituto de Investigación Marqués de Valdecilla (ES), Hospital Clínic de Barcelona (ES), National Pancreas Foundation (US), Hospital Universitario Doctor Peset (ES), Hospital de Santo António (PT), Instituto Ramón y Cajal de Investigación Sanitaria (ES), Hospital Clínico de la Universidad de Chile (CL), Universidad Privada Boliviana (BO), Hospital Universitario Central de Asturias (ES), Instituto de Gastroenterología (CU), Hospital of St. Francis Xavier (PT), Hospital de Cruces (ES), Hospital General Universitario de Alicante Doctor Balmis (ES), Servicio Diabetología Hospital Córdoba (AR), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR), Universidad Tecnológica del Perú (PE), Hospital Universitario San Ignacio (CO), Hospital de Clínicas (UY), St Martins Hospital (GB), Hospital Universitario Ramón y Cajal (ES), Complejo Hospitalario de Ourense (ES), Fundacion Allende (AR), Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL) (ES), Universidad de Montevideo (UY), Universitat de Barcelona (ES), Universidad Nacional Autónoma de México (MX)
Openalex Percentile: Top 4%
Pancreatitis Pathology and Treatment
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