European survey of surgical strategies for the management of severe acute pancreatitis

OBJECTIVES: This study is the first pan-European survey of surgical strategies for the management of severe acute pancreatitis. METHODS: A questionnaire survey was undertaken of the 866 members of the European chapter of the International Hepato-Pancreato-Biliary Association (IHPBA). There were 329 replies from practicing clinicians giving a response rate of 38%. RESULTS: The modal case volume was 11-20 patients per year. Severity stratification was used by 324 (99%) respondents with the Ranson score being the most popular. Antibiotic prophylaxis was utilized by 239 (73%) with the median duration being 7 days (range 1-28; 95% Cl: 8-9). Fine needle aspiration of necrosis was undertaken by 174 (53%) and 131 would operate on a patient with a positive result. There was no consensus on optimum timing of surgery. CONCLUSIONS: The results of this first pan-European questionnaire demonstrate wide variations in care. Overall, the findings provide a unique insight into the current management of severe acute pancreatitis in Europe.