United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis (HaPanEU)

被引：484

作者：

Lohr, J. Matthias ^{[1
]}

Dominguez-Munoz, Enrique ^{[2
]}

Rosendahl, Jonas ^{[3
]}

Besselink, Marc ^{[4
]}

Mayerle, Julia

Lerch, Markus M. ^{[5
]}

Haas, Stephan ^{[1
]}

Akisik, Fatih ^{[6
]}

Kartalis, Nikolaos ^{[7
,8
]}

Iglesias-Garcia, Julio ^{[2
]}

Keller, Jutta ^{[10
]}

Boermeester, Marja ^{[4
]}

Werner, Jens ^{[11
]}

Dumonceau, Jean-Marc ^{[12
]}

Fockens, Paul ^{[4
,9
]}

Drewes, Asbjorn ^{[13
]}

Ceyhan, Guerlap ^{[14
]}

Lindkvist, Bjorn ^{[15
]}

Drenth, Joost P. H. ^{[16
]}

Ewald, Nils ^{[17
]}

Hardt, Philip ^{[17
]}

de Madaria, Enrique ^{[18
]}

Witt, Heiko ^{[19
]}

Schneider, Alexander ^{[20
]}

Manfredi, Riccardo ^{[21
]}

Brondum, Frokjer J. ^{[22
]}

Rudolf, Sasa ^{[23
]}

Bollen, Thomas ^{[24
]}

Bruno, Marco ^{[25
,26
]}

机构：

[1] Karolinska Univ Hosp, Ctr Digest Dis, Stockholm, Sweden

[2] Univ Hosp Santiago Compostela, Dept Gastroenterol & Hepatol, Santiago De Compostela, Spain

[3] Univ Leipzig, Dept Gastroenterol, Leipzig, Germany

[4] Acad Med Ctr Amsterdam, Dept Surg, Amsterdam, Netherlands

[5] Univ Med Greifswald, Dept Med, Greifswald, Germany

[6] Indiana Univ, Dept Radiol, Indianapolis, IN 46204 USA

[7] Karolinska Univ Hosp, Dept Radiol, Stockholm, Sweden

[8] Karolinska Inst, CLINTEC, Div Med Imaging & Technol, Stockholm, Sweden

[9] Acad Med Ctr, Dept Gastroenterol & Hepatol, Amsterdam, Netherlands

[10] Univ Hamburg, Israelit Hosp Hamburg, Hamburg, Germany

[11] Ludwig Maximilians Univ Munchen, Munich, Germany

[12] Univ Geneva, Geneva, Switzerland

[13] Aarhus Univ, Dept Gastroenterol, Aarhus, Denmark

[14] Tech Univ Munich, Klinikum Rechts Isar, D-80290 Munich, Germany

[15] Gothenburg Univ, Gothenburg, Sweden

[16] Radboud Univ Nijmegen, Med Ctr, Dept Gastroenterol & Hepatol, Nijmegen, Netherlands

[17] Justus Liebig Univ Giessen, Giessen, Germany

[18] Hosp Gen Univ, Alicante, Spain

[19] Tech Univ Munich, Munich, Germany

[20] Univ Hosp Mannheim, Mannheim, Germany

[21] Univ Verona, Dept Radiol, Verona, Italy

[22] Aalborg Univ, Aalborg, Denmark

[23] Univ Med Ctr Maribor, Dept Radiol, Maribor, Slovenia

[24] St Antonius Hosp, Nieuwegein, Netherlands

[25] Erasmus MC, Dept Gastroenterol & Hepatol, Rotterdam, Netherlands

[26] Klinikum Ludwig Maximilians Univ, Med Klin & Poliklin 2, Munich, Germany

来源：

UNITED EUROPEAN GASTROENTEROLOGY JOURNAL | 2017年 / 5卷 / 02期

关键词：

Chronic pancreatitis; Grading of Recommendations Assessment; Development and Evaluation; evidence-based; guidelines; pancreatic exocrine insufficiency; diabetes mellitus; endoscopic therapy; EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY; EXPANDABLE METAL STENT; LONG-TERM; CYSTIC DYSTROPHY; REPLACEMENT THERAPY; ENDOSCOPIC THERAPY; DUCT STRICTURES; DUODENAL WALL; FOLLOW-UP; MANAGEMENT;

D O I：

10.1177/2050640616684695

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

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.

引用

页码：153 / 199

页数：47

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