Japanese (JPN) guidelines for the management of acute pancreatitis

As President of the Japanese Society for Abdominal Emergency Medicine, Takada, myself, declared in 1990 that I would work on the Japanese (JPN) guidelines for the management of acute pancreatitis as the first clinical practice guidelines in Japan to incorporate the methods of evidence-based medicine. At that time, the mortality rate of severe acute pancreatitis was as high as 30%, and severe acute pancreatitis was designated as an intractable disease by the Ministry of Health, Labor and Welfare's Research Project for Overcoming Intractable Diseases.
Under these circumstances, we published the first edition of JPN guidelines for the management of acute pancreatitis in 2003. Subsequently, the second edition was published in 2007, the third edition in 2010,and the fourth edition in 2015, with the aim of maintaining scientifically reliable guidelines using the latest methods. Thereafter, the case-fatality rate of severe cases had been markedly reduced to 10.1% in 2011, due to the combination of advances in treatment modalities and the spread of the guidelines, and thus severe acute pancreatitis was removed from the intractable disease designation in 2014. In preparing the current 2021 revision, we focused on the issues raised by the results of nationwide epidemiological survey in 2016: the existence of a group of cases with no improvement in the case-fatality rate, and the fact that some of the guideline recommendations are not being implemented. As one of the measures to address these issues, a unique educational tool of the “easy-to-understand explanations” file has been added so that not only physicians but also medical professionals, students, patients, and their families can understand the management of acute pancreatitis and respond together as one team, because the importance of multidisciplinary team medicine has become apparent in recent years.
We have submitted our paper to JHBPS in the hope that the contents of this guidelines will be widely understood through our new efforts.

Tadahiro Takada, MD. PhD,
Founding Editor-in-Chief


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