ArticleDigestive diseases and sciences2026
Management of Idiopathic Acute Pancreatitis in Europe: An International Pancreas2000 Survey.
Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIdentifying the underlying cause of acute pancreatitis is fundamental for prevention of recurrence. However, no standardised algorithm for determining its aetiology exists.
aimsThis survey study aimed to investigate the international variations in diagnosis, workup protocols and follow-up of acute pancreatitis.
methodsA 37-item international questionnaire was developed by a multidisciplinary team within the Pancreas 2000 program. The survey was distributed through social media platforms, e-mails and conference presentations. Responses were collected anonymously.
resultsThe survey received 247 responses from 36 countries, with 96% of respondents based in Europe; there were 56% gastroenterologists (N = 138), 34% surgeons (N = 84). Endoscopic ultrasound and magnetic resonance cholangiopancreatography were equally chosen as the preferred initial diagnostic test (34%, N = 85 each) in cases of acute pancreatitis without identified aetiology after the standard workup. Compared to surgeons, gastroenterologists used endoscopic ultrasound more (5% vs. 29%, p < 0.001) and favoured it as the ideal initial diagnostic tool for determining the aetiology (17% vs. 41%, p < 0.001). Most respondents (79%, N = 194) didn't recommend cholecystectomy when there was no evidence of biliary aetiology. The majority (89%, N = 220) recommended follow-up for moderate and severe acute pancreatitis with an unknown aetiology after initial admission; 17% (N = 42) did not recommend any follow-up.
conclusionsThis survey reveals significant disparities in the methods used to determine the aetiology of acute pancreatitis across different regions and centres within Europe. We share a common understanding that identifying the acute pancreatitis aetiology is critical to prevent recurrence. However, the absence of a validated protocol for this process is a notable gap in the clinical practice.
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