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Treatment Gastroenterology

Acute Pancreatitis

Treatment for acute pancreatitis depends on the severity of the attack. Many cases get better with time, unless complications develop. Usually, patients are hospitalized to receive intravenous fluids to restore blood volume and hydration as well as medications to control pain. Antibiotics may be given if an infection occurs.

Dietary guidelines are usually prescribed to reduce the fat you eat, since your body has trouble digesting these substances.


Surgery may be needed if complications such as infection, cysts or bleeding occur. If gallstrones are the cause of your attack, the gallbladder may be removed.

If a bile duct obstruction is suspected of causing the pancreatitis, a procedure called an endoscopic retrograde cholangiopancreatography (ERCP) may be performed. A flexible tube is inserted down the throat into the stomach and small intestines. Dye is injected into the drainage tube of the pancreas to locate the possible obstruction. Special instruments are inserted through the endoscope or tube to remove the obstruction or stretch a narrowing segment of the bile duct.

Patients with severe acute pancreatitis may develop pancreatic necrosis, a serious infection in which tissue within the pancreas dies and later becomes infected. This results in a condition called acute necrotizing pancreatitis. An abscess may form on the dead tissue several weeks after an attack of acute necrotizing pancreatitis.

Surgeons in the Complex Abdominal Surgery Program at UCSF Medical Center have developed surgical techniques for severe acute pancreatitis, including blunt necrosectomy and the minimally invasive, step-up necrosectomy to remove the dead tissue. With new techniques to manage the disease, these procedures result in decreased severity of illness and fewer deaths. The death rate of patients with severe acute pancreatitis at UCSF is two to three times less than the national average.

Patients with severe acute pancreatitis have an average hospital stay of two months, followed by a lengthy recovery period.

Our team of specialists — including those in gastrointestinal surgery, nursing, nutrition, intensive-care medicine, wound care, plastic surgery, pharmacology and infectious disease — work together to customize a treatment plan for each patient.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

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