• Vinciane Rebours, Philippe Lévy, Jean-François Bretagne, Gilles Bommelaer, Pascal Hammel, and Philippe Ruszniewski.
• Pôle des Maladies de l'Appareil Digestif, Pancreatology Unit, Beaujon Hospital, Denis Diderot-Paris VII University, AP-HP, Clichy, France. vinciane.rebours@bjn.aphp.fr
• Eur J Gastroenterol Hepatol. 2012 Feb 1; 24 (2): 143-8.

ObjectivesThe elaboration and publication of guidelines should help homogenizing the management of frequent diseases with high mortality and morbidity rates, such as acute pancreatitis.AimTo evaluate the implementation of French guidelines on the management of acute pancreatitis (AP), and to correlate changes with a received medical training course.MethodsIn 2001 (before the Consensus Conference) and 2008, the same questionnaire dealing with recommendations for AP management was sent to the French gastroenterology Units. Responses in 2001 and 2008 were compared.ResultsOne hundred and seventy-six questionnaires were analyzed (public hospitals: 62%, academic hospitals: 20%, private institutions: 18%). In 2008 (vs. 2001), lipase levels were measured for establishing AP diagnosis by 99% (vs. 83%). To evaluate AP severity, a computed tomography (CT) scan was performed at 48 h by 69% (vs. 29%, P ≤ 0.001). The most used severity index was the CT Balthazar score 76% (vs. 55%, P ≤ 0.001). Antibiotic prophylaxis and artificial nutrition by enteral route were proposed by 20% (vs. 57%) and 58% (vs. 25%) for necrotizing pancreatitis. Practices were more frequently in agreement with the guidelines in public nonacademic and academic hospitals. Training course on AP management was associated with a more appropriate use of CT scan for the evaluation of AP severity and of antibiotics.ConclusionMajor changes were noticed since the publication of the French guidelines. Although establishing guidelines is an expensive process, it does increase compliance with best evidence-based practice.

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