• Pieter Sinonquel, Wim Laleman, and Alexander Wilmer.
• Department of Gastroenterology and Hepatology, University Hospitals Leuven.
• Curr Opin Crit Care. 2021 Apr 1; 27 (2): 193-200.

Purpose Of ReviewWith a potentially life-threatening course, acute pancreatitis (AP) is one of the most common gastrointestinal diseases requiring hospitalization and often necessitating intensive care. Based on recent insights and recommendations, this review provides an overview on clinical management of AP patients with a focus on intensive care unit care.Recent FindingsPossible benefits of percutaneous paracentesis and/or drainage on outcome or inflammation have been further explored. Combined opioid and epidural analgesia for pain management might be a valuable alternative for pain management. Very recent international guidelines now agree on a step-up approach for the management of acute necrotizing pancreatitis favoring a minimally invasive approach with either endoscopic or percutaneous drainage first. Studies for the best timing of these interventions are ongoing. In spite of a better understanding of pathophysiological mechanisms mediating AP, specific treatments are still awaited.SummaryNew evidence and recent international consensus direct the current management of AP toward a tailored, multidisciplinary and less invasive therapy with complementary roles for hepatologists, intensivists, radiologists, and surgeons.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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