Hole in the wall - more comments to "ESPEN guideline on clinical nutrition in acute and chronic pancreatitis".

Abstract

We read with great interest the new “ESPEN guideline on clinical nutrition in acute and chronic pancreatitis” [1]. Although the majority of patients with mild form of acute pancreatitis (AP) recover within a week, necrotizing pancreatitis is a devastating disease that results in a multitude of systemic and local complications requiring prolonged intensive care unit stay and need for invasive interventions. Since we are witnessing substantial advances in invasive procedures for local complications of AP that have shifted the paradigm towards minimally invasive surgical and endoscopic step-up approaches, it is our opinion that the recommendation addressing “medical nutrition therapy in case of necrosectomy (endoscopically or by minimally invasive surgery) in patients with severe AP” necessitates further clarification.