Controversies in the management of acute pancreatitis: An update

This review discusses the ongoing controversies in managing acute pancreatitis (AP), focusing on fluid resuscitation, nutrition, antibiotics, analgesics, anticoagulation, and interventions for complications. Current evidence supports the use of crystalloids for fluid resuscitation, while early enteral feeding is generally preferred for nutrition. The use of antibiotics and antifungals remains uncertain, requiring more data for clear guidelines. Analgesic choices and the role of anticoagulation are still under study. Interventions are shifting towards endoscopy or percutaneous drainage over surgery. More multicenter randomized controlled trials are needed to establish standard care practices to reduce AP-related morbidity and mortality.