Use of Prognostic Markers in The Management of Acute Pancreatitis

Management of acute pancreatitis (AP) is tailored by its severity, which is defined at 48 hr by the revised Atlanta or determinant-based classification. However, using these classifications, it is probably too late to offer any treatment that might change natural course of AP. The best markers for ruling out severe AP within the first day are APACHE II score. Marker that can rule-out pancreatic necrosis in case imaging study could not be done is Creactive protein (CRP) <150 mg/L after 3 days. Markers that help indicate infected pancreatic necrosis in case fine needle aspiration could not be performed is procalcitonin ≥ 3.5 ng/mL (rule-in) and CRP <430 mg/L (rule-out).