Great improvement in acute pancreatitis care

Published Date: 19th July 2016

Publication Authors: Maitra D

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Introduction

The British Society of Gastroenterologists (BSG) updated guidelines on the management of acute pancreatitis in2005.This audit aimed to improve acute pancreatitis care in accordance with those guidelines.

Methods

An initial audit of all 39 patients with acute pancreatitis in October-December 2011 was undertaken. Improvements were made through arranging group teaching for junior doctors, extra cholecystectomy lists, a 7-days per week ultrasound service (5-days previously) and combined microbiology and surgical ward rounds. Liaison with gastroenterologists improved ERCP availability. A retrospective re-audit was undertaken of all 50 patients in February-March 2013 to complete the audit cycle.

Results

Modified Glasgow Score was completed in 98% of re-audit cases (85% previously). Antibiotic prescription was considered appropriate in 90% (47%). Gallstone pancreatitis was managed by cholecystectomy, either as an inpatient or within two weeks, in 77% (10%). Ultrasound was performed within 24 hours of admission in 66% (28%), ERCP was delayed in 2% (5%) and overall mortality was 8% (10%).

Conclusions

Acute pancreatitis care was improved following several changes. Current care follows recommended guidelines but there is room for improvement, notably in improving ultrasound access and managing gallstone pancreatitis.

Davies, P; Bader, H; Battersby, C; Maitra, D. (2014).  A closed loop audit demonstrates great improvement in acute pancreatitis care . International Journal of Surgery. 12 (Supple 3), S46.

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