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Acute Pancreatitis: Clinical Management and Treatment
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Acute Pancreatitis: Clinical Management and Treatment

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: 21 August 2025 | Viewed by 1062

Special Issue Editors

Prof. Dr. Sorin Traian Barbu

E-Mail Website
Guest Editor
Surgery Department Clinical CF Hospital Cluj, University of Medicine and Pharmacy "Iuliu Hatieganu”, 400015 Cluj-Napoca, Romania
Interests: pancreatic diseases; pancreatitis (acute & chronic); pancreatic cancer; HPB surgery; oncologic surgery; laparoscopic surgery
Prof. Dr. Valeriu Surlin

E-Mail Website1 Website2
Guest Editor
1. Department of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
2. First Clinic of Surgery, Craiova Emergency Clinical County Hospital, 200642 Craiova, Romania
Interests: abdominal surgery; surgical oncology; gastrointestinal surgery; colorectal surgery; hernia surgery; laparoscopic surgery; laparoscopic cholecystectomy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Acute pancreatitis (AP) is a common gastrointestinal disease requiring acute hospitalization, with a continuous growing incidence, and a high financial burden for the health system. AP is heterogenous, progressing differently among patients and is often unpredictable. Most of the cases are mild forms with low morbidity and mortality, but severe AP mortality is as high as 30%. The need for a multidisciplinary approach in AP, including imaging, gastroenterology, intensive care, surgery, endoscopy, nutrition, endocrinology, etc., is crucial.

This JCM Special Issue aims to collect high-quality reviews, meta-analyses, original articles, and communications with a potential impact on the AP clinical management and treatment. The Special Issue focuses on all aspects of AP management, starting from relevant diagnostic techniques and early diagnosis, early severity assessment using biological and severity markers, and early multidisciplinary management and an aggressive treatment, which are essential to prevent evolution to complications, especially infected necrosis or infected fluid collection. Evidence-based up-to date step-up approaches and nutrition must also be included in AP management. The research areas of this Special Issue are not limited to the above-mentioned topics.

We look forward to receiving your contributions.  

Prof. Dr. Sorin Traian Barbu
Prof. Dr. Valeriu Surlin
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • acute pancreatitis
  • classification
  • complications
  • intervention
  • management
  • prevention
  • severity
  • treatment

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Published Papers (2 papers)

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Research

13 pages, 1054 KiB  
Article
The Stress Hyperglycemia Ratio as a Predictor of Clinical Outcomes in Acute Pancreatitis: A Retrospective Cohort Study
by Ping Zhu, Xinwei Wang, Cheng Hu, Xiaoxin Zhang, Ziqi Lin, Tao Jin, Lan Li, Na Shi, Xinmin Yang, Wei Huang, Qing Xia and Lihui Deng
J. Clin. Med. 2025, 14(14), 4970; https://doi.org/10.3390/jcm14144970 - 14 Jul 2025
Viewed by 413
Abstract
Background: The stress hyperglycemia ratio (SHR) has emerged as a promising biomarker for assessing stress-induced hyperglycemia (SH) but has not been evaluated in patients with acute pancreatitis (AP). This study investigates the role of the SHR in predicting adverse clinical outcomes in [...] Read more.
Background: The stress hyperglycemia ratio (SHR) has emerged as a promising biomarker for assessing stress-induced hyperglycemia (SH) but has not been evaluated in patients with acute pancreatitis (AP). This study investigates the role of the SHR in predicting adverse clinical outcomes in patients with AP. Methods: Adult patients with AP who were admitted within 72 h of the onset of abdominal pain were screened in the database. Eligible patients with glycated hemoglobin (HbA1c) and blood glucose were analyzed. The SHR was calculated using admission blood glucose and HbA1c levels. Patients were categorized into four groups: SHR1 (≤1.03), SHR2 (1.04–1.25), SHR3 (1.26–1.46), and SHR4 (≥1.47). The primary outcome was persistent organ failure (POF). The secondary outcomes included acute peripancreatic fluid collection (APFC) and high-dependency unit/intensive care unit (HDU/ICU) admission. Restricted cubic spline (RCS) analysis was used to assess nonlinear associations and identify SHR threshold values. Univariable and multivariable logistic regression models were used to adjust for potential confounders and evaluate the relationship between the SHR and clinical outcomes. Results: A total of 486 patients with AP were included in this study, comprising 85 with POF and 401 without POF. SHR levels and severity were significantly correlated, with the highest quartile in the greatest proportion of severe acute pancreatitis (SAP). Higher SHR levels were significantly associated with an increased risk of POF, APFC, and HDU/ICU admission. RCS analysis revealed a nonlinear relationship between the SHR and APFC (p = 0.009). Based on the RCS and quartile analysis, SHR > 1.25 was identified as the threshold for increased risk. After adjusting for confounders, SHR > 1.25 remained independently associated with higher risks of POF (OR: 2.49, 95% CI: 1.39–4.46, p = 0.002), APFC (OR: 2.85, 95% CI: 1.92–4.24, p < 0.001), and ICU admission (OR: 1.74, 95% CI: 1.12–2.69, p = 0.013). Conclusions: The SHR is independently associated with adverse clinical outcomes in AP, including POF, APFC, and HDU/ICU admission. These findings suggest that the SHR may serve as a valuable biomarker for risk stratification and early intervention in AP management. Full article
(This article belongs to the Special Issue Acute Pancreatitis: Clinical Management and Treatment)
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17 pages, 1830 KiB  
Article
From Inflammation to Dysfunction: The Impact of a First Acute Pancreatitis Episode on Pancreatic Function
by Marina Balaban, Daniel Vasile Balaban, Iulia Enache, Ioan Cristian Nedelcu, Mariana Jinga and Cristian Gheorghe
J. Clin. Med. 2025, 14(14), 4932; https://doi.org/10.3390/jcm14144932 - 11 Jul 2025
Viewed by 358
Abstract
Background/Objectives: The complexity of acute pancreatitis (AP) extends beyond its immediate complications. This study aimed to evaluate both exocrine and endocrine pancreatic dysfunctions following a first episode of AP, assessed at diagnosis and during a 6-month follow-up period. Methods: A prospective [...] Read more.
Background/Objectives: The complexity of acute pancreatitis (AP) extends beyond its immediate complications. This study aimed to evaluate both exocrine and endocrine pancreatic dysfunctions following a first episode of AP, assessed at diagnosis and during a 6-month follow-up period. Methods: A prospective analysis was conducted on patients with a first episode of AP. Pancreatic endocrine function was evaluated using fasting glucose and glycated hemoglobin (HbA1c) levels, while pancreatic exocrine function was assessed through fecal elastase-1 (FE-1) testing and the novel Pancreatic Exocrine Insufficiency Questionnaire (PEI-Q). Results: Altogether, data from 112 time-point observations were analyzed with respect to endocrine and exocrine insufficiency after a first episode of AP, with 60 patients enrolled at baseline, 33 (55%) completing the first follow-up, and 19 (31.67%) completing the second follow-up. Based on PEI-Q scores, 75% of patients showed pancreatic exocrine insufficiency (PEI) at baseline. This rate decreased significantly to 33.3% at 2 months, with a further slight decline to 26.3% at 6 months. In contrast, FE-1 testing identified PEI in only 23% of patients at baseline, with a similar progressive improvement in time. Regarding the endocrine function, hyperglycemia was noted at baseline (mean serum glucose 120.75 ± 49.89 mg/dL), with a decreasing trend and normalization observed at follow-up. Conclusions: The pancreas has a remarkable recovery potential, with both exocrine and endocrine dysfunctions seen during the hospitalization for AP being transient. However, follow-up after AP is essential, as pancreatic insufficiency can significantly impact patients’ quality of life. Full article
(This article belongs to the Special Issue Acute Pancreatitis: Clinical Management and Treatment)
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