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Acute Pancreatitis and Its Complications: Current Diagnostics and Management
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Acute Pancreatitis and Its Complications: Current Diagnostics and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 20 March 2026 | Viewed by 1118

Special Issue Editor

Dr. Beata Jabłońska

E-Mail Website
Guest Editor
Department of Digestive Tract Surgery, Medical University of Silesia, Katowice, Poland
Interests: gastrointestinal surgery; oncological surgery; vascular surgery; gastroenterology; angiology; oncology; nutritional status; nutrition
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Acute pancreatitis (AP) is defined as acute inflammation of the pancreas leading to potential local or systemic complications. According to the 2012 revision of the Atlanta Classification, AP is categorized into mild AP (MAP), moderately severe AP (MSAP), and severe AP (SAP). Assessment of AP severity is crucial for appropriate management, and various scores are used to assess the AP severity.

In 5–10% patients, pancreatic and/or peripancreatic necrosis is observed. Pancreatic and peripancreatic necrosis may remain solid or liquefy, remain sterile or become infected, persist, or disappear over time.

Atlanta classification has distinguished acute peripancreatic fluid collection (APFC), pancreatic pseudocyst (PPC), acute necrotic collection (ANC), and walled-off necrosis (WON). Recently, a significant evolution of the management in patients with AP complications, including PPC and WON, has been observed. The older surgical methods of treatment have been replaced by less invasive percutaneous radiological and endoscopic approaches. This Special Issue on “Acute Pancreatitis and Its Complications – Current Diagnostics and Management” will cover all aspects of diagnostic and therapeutic methods used in AP patients. I invite original research and review papers regarding various laboratory tests and radiological investigations, prognostic scores, and surgical and less invasive techniques used in AP patients.

Dr. Beata Jabłońska
Guest Editor

Manuscript Submission Information

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Keywords

  • acute pancreatitis
  • pancreas
  • pancreatic and peripancreatic necrosis
  • management
  • less invasive percutaneous radiological and endoscopic approaches

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Published Papers (2 papers)

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Research

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16 pages, 994 KB  
Article
Impact of Alcoholic Etiology on Mortality and Clinical Outcome in Acute Pancreatitis: A Retrospective Cohort Study Across the COVID-19 Pandemic
by Cristian-Nicolae Costea, Radu Seicean, Cristina Pojoga, Vlad-Ionuț Nechita, Irina Dragomir, Mihaela Oancea, Mariana Toma and Andrada Seicean
J. Clin. Med. 2025, 14(18), 6551; https://doi.org/10.3390/jcm14186551 - 17 Sep 2025
Viewed by 348
Abstract
Background/Objectives: Alcoholic acute pancreatitis (AP) is a major cause of hospital admissions in Eastern Europe. However, data from secondary-care centers on the impact of the COVID-19 pandemic are limited. Methods: We retrospectively analyzed all adult AP admissions to a secondary-care hospital between March [...] Read more.
Background/Objectives: Alcoholic acute pancreatitis (AP) is a major cause of hospital admissions in Eastern Europe. However, data from secondary-care centers on the impact of the COVID-19 pandemic are limited. Methods: We retrospectively analyzed all adult AP admissions to a secondary-care hospital between March 2018 and March 2025. Cases were classified by etiology and grouped into pre-pandemic, pandemic, and post-pandemic periods. We compared demographic, clinical, severity, recurrence, outcome, resource use, and cost data between alcoholic and non-alcoholic AP. Results: Among 1096 patients (63.5% male; median age 55 years), alcohol was the leading etiology (40.1%), peaking during the pandemic. Alcoholic AP was more common in men, rural residents, and smokers, and less common in patients with obesity or diabetes. Recurrence was higher in alcoholic AP (21.8% vs. 15.9%; p = 0.015). Severe disease was more frequent in alcoholic than biliary AP (38.4% vs. 22.3%; p = 0.001). Overall mortality was 8.4%, declining after the pandemic (10.4% pre-pandemic vs. 6.5% post-pandemic). In multivariable Cox models, pleural effusion (HR 7.88; 95% CI 3.27–18.99) and age (HR 1.02; 95% CI 1.00–1.03) independently predicted mortality in the overall cohort. In alcoholic AP, pleural effusion was the only independent predictor (HR 13.19; 95% CI 2.48–70.08). In non-alcoholic AP, pleural effusion (HR 6.83; 95% CI 2.40–19.44) and signs of shock (HR 3.49; 95% CI 1.14–10.71) were independent predictors. Conclusions: Alcoholic AP was the most frequent etiology, with higher recurrence and severity than biliary AP, but alcoholic etiology itself did not predict mortality. Mortality drivers differed by etiology: pleural effusion in alcoholic AP, and pleural effusion plus signs of shock in non-alcoholic AP. ICU transfer was associated with death in descriptive analyses but was treated as a downstream mediator and not included in adjusted models. Full article
(This article belongs to the Special Issue Acute Pancreatitis and Its Complications: Current Diagnostics and Management)
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Review

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27 pages, 5450 KB  
Review
Pancreatic Pseudocysts: Evolution of Treatment Approaches
by Paulina Kluszczyk, Aleksandra Tobiasz, Adam Madej, Piotr Wosiewicz, Sławomir Mrowiec and Beata Jabłońska
J. Clin. Med. 2025, 14(17), 6152; https://doi.org/10.3390/jcm14176152 - 30 Aug 2025
Viewed by 611
Abstract
Pancreatic pseudocysts (PPCs) are frequent complications of acute and chronic pancreatitis, characterized by encapsulated collections of pancreatic fluid. Historically managed by open surgical approaches, treatment paradigms have significantly evolved with advancements in imaging and minimally invasive techniques. This review outlines the historical progression [...] Read more.
Pancreatic pseudocysts (PPCs) are frequent complications of acute and chronic pancreatitis, characterized by encapsulated collections of pancreatic fluid. Historically managed by open surgical approaches, treatment paradigms have significantly evolved with advancements in imaging and minimally invasive techniques. This review outlines the historical progression and current standards in PPC management, covering conservative, surgical, laparoscopic, and endoscopic interventions. Conservative management remains a valid first-line option for asymptomatic, stable pseudocysts, particularly in the absence of complications. Surgical techniques, once the mainstay, such as marsupialization and internal drainage procedures (cystogastrostomy, cystojejunostomy, and cystoduodenostomy), now serve as alternatives when less invasive methods fail. Laparoscopic approaches offer reduced morbidity and faster recovery, especially for complex or inaccessible PPCs. However, endoscopic drainage, particularly endoscopic ultrasound-guided transmural drainage using plastic or metal stents—especially lumen-apposing metal stents (LAMSs)—has become the preferred modality due to its efficacy, safety profile, and cost effectiveness. Emerging technologies, including robotic-assisted surgery and hybrid techniques, promise further refinement in PPC management. This review synthesizes current evidence and expert guidelines, providing a comprehensive overview of evolving strategies and future directions in the treatment of PPCs. Full article
(This article belongs to the Special Issue Acute Pancreatitis and Its Complications: Current Diagnostics and Management)
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