Open AccessUnited European Gastroenterology evidence‐based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU)
Author(s) -
Löhr J Matthias,
DominguezMunoz Enrique,
Rosendahl Jonas,
Besselink Marc,
Mayerle Julia,
Lerch Markus M,
Haas Stephan,
Akisik Fatih,
Kartalis Nikolaos,
IglesiasGarcia Julio,
Keller Jutta,
Boermeester Marja,
Werner Jens,
Dumonceau JeanMarc,
Fockens Paul,
Drewes Asbjorn,
Ceyhan Gürlap,
Lindkvist Björn,
Drenth Joost,
Ewald Nils,
Hardt Philip,
Madaria Enrique,
Witt Heiko,
Schneider Alexander,
Manfredi Riccardo,
Brøndum Frøkjer J,
Rudolf Sasa,
Bollen Thomas,
Bruno Marco
Publication year - 2017
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640616684695
Subject(s) - medicine , pancreatitis , grading (engineering) , delphi method , gastroenterology , general surgery , intensive care medicine , statistics , civil engineering , mathematics , engineering
Background There have been substantial improvements in the management of chronic pancreatitis, leading to the publication of several national guidelines during recent years. In collaboration with United European Gastroenterology, the working group on ‘Harmonizing diagnosis and treatment of chronic pancreatitis across Europe’ (HaPanEU) developed these European guidelines using an evidence‐based approach. Methods Twelve multidisciplinary review groups performed systematic literature reviews to answer 101 predefined clinical questions. Recommendations were graded using the Grading of Recommendations Assessment, Development and Evaluation system and the answers were assessed by the entire group in a Delphi process online. The review groups presented their recommendations during the 2015 annual meeting of United European Gastroenterology. At this one‐day, interactive conference, relevant remarks were voiced and overall agreement on each recommendation was quantified using plenary voting (Test and Evaluation Directorate). After a final round of adjustments based on these comments, a draft version was sent out to external reviewers. Results The 101 recommendations covered 12 topics related to the clinical management of chronic pancreatitis: aetiology (working party (WP)1), diagnosis of chronic pancreatitis with imaging (WP2 and WP3), diagnosis of pancreatic exocrine insufficiency (WP4), surgery in chronic pancreatitis (WP5), medical therapy (WP6), endoscopic therapy (WP7), treatment of pancreatic pseudocysts (WP8), pancreatic pain (WP9), nutrition and malnutrition (WP10), diabetes mellitus (WP11) and the natural course of the disease and quality of life (WP12). Using the Grading of Recommendations Assessment, Development and Evaluation system, 70 of the 101 (70%) recommendations were rated as ‘strong' and plenary voting revealed ‘strong agreement' for 99 (98%) recommendations. Conclusions The 2016 HaPanEU/United European Gastroenterology guidelines provide evidence‐based recommendations concerning key aspects of the medical and surgical management of chronic pancreatitis based on current available evidence. These recommendations should serve as a reference standard for existing management of the disease and as a guide for future clinical research.