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The 2023 MANCTRA Acute Biliary Pancreatitis Care Bundle: A Joint Effort Between Human Knowledge and Artificial Intelligence (ChatGPT) to Optimize the Care of Patients With Acute Biliary Pancreatitis in Western Countries.
Podda, Mauro; Di Martino, Marcello; Ielpo, Benedetto; Catena, Fausto; Coccolini, Federico; Pata, Francesco; Marchegiani, Giovanni; De Simone, Belinda; Damaskos, Dimitrios; Mole, Damian; Leppaniemi, Ari; Sartelli, Massimo; Yang, Baohong; Ansaloni, Luca; Biffl, Walter; Kluger, Yoram; Moore, Ernest E; Pellino, Gianluca; Di Saverio, Salomone; Pisanu, Adolfo.
Afiliação
  • Podda M; Department of Surgical Science, Emergency Surgery Unit, Cagliari State University Hospital, Cagliari, Italy.
  • Di Martino M; Division of Hepatobiliary and Liver Transplantation Surgery, A.O.R.N. Cardarelli, Naples, Italy.
  • Ielpo B; Hepatobiliary Division, Hospital del Mar, Pompeu Fabra University, Barcelona, Spain.
  • Catena F; Department of Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy.
  • Coccolini F; General, Emergency and Trauma Surgery Unit, Pisa University Hospital, Pisa, Italy.
  • Pata F; Department of Surgery, University of Calabria, Cosenza, Italy.
  • Marchegiani G; Department of Surgical, Oncological and Gastroenterological Sciences (DISCOG), Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Padua, Padua, Italy.
  • De Simone B; Department of Emergency and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal de Poissy/Saint Germain en Laye, Poissy Cedex, France.
  • Damaskos D; Department of Upper GI Surgery, Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.
  • Mole D; Centre for Inflammation Research, Clinical Surgery, University of Edinburgh, Edinburgh, Scotland, UK.
  • Leppaniemi A; Department of Abdominal Surgery, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
  • Sartelli M; Department of Surgery, Macerata Civil Hospital, Macerata, Italy.
  • Yang B; Department of Oncology, Weifang People's Hospital, The First Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China.
  • Ansaloni L; Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
  • Biffl W; Department of General Surgery, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
  • Kluger Y; Division of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA.
  • Moore EE; Department of General Surgery, Rambam Medical Center, Haifa, Israel.
  • Pellino G; Denver Health System-Denver Health Medical Center, Denver, CO.
  • Di Saverio S; "Luigi Vanvitelli" University of Campania, Naples, Italy.
  • Pisanu A; Department of Colorectal Surgery, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona UAB, Barcelona, Spain.
Ann Surg ; 279(2): 203-212, 2024 Feb 01.
Article em En | MEDLINE | ID: mdl-37450700
OBJECTIVE: To generate an up-to-date bundle to manage acute biliary pancreatitis using an evidence-based, artificial intelligence (AI)-assisted GRADE method. BACKGROUND: A care bundle is a set of core elements of care that are distilled from the most solid evidence-based practice guidelines and recommendations. METHODS: The research questions were addressed in this bundle following the PICO criteria. The working group summarized the effects of interventions with the strength of recommendation and quality of evidence applying the GRADE methodology. ChatGPT AI system was used to independently assess the quality of evidence of each element in the bundle, together with the strength of the recommendations. RESULTS: The 7 elements of the bundle discourage antibiotic prophylaxis in patients with acute biliary pancreatitis, support the use of a full-solid diet in patients with mild to moderately severe acute biliary pancreatitis, and recommend early enteral nutrition in patients unable to feed by mouth. The bundle states that endoscopic retrograde cholangiopancreatography should be performed within the first 48 to 72 hours of hospital admission in patients with cholangitis. Early laparoscopic cholecystectomy should be performed in patients with mild acute biliary pancreatitis. When operative intervention is needed for necrotizing pancreatitis, this should start with the endoscopic step-up approach. CONCLUSIONS: We have developed a new care bundle with 7 key elements for managing patients with acute biliary pancreatitis. This new bundle, whose scientific strength has been increased thanks to the alliance between human knowledge and AI from the new ChatGPT software, should be introduced to emergency departments, wards, and intensive care units.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pancreatite Necrosante Aguda / Pacotes de Assistência ao Paciente Tipo de estudo: Guideline Limite: Humans Idioma: En Revista: Ann Surg Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Itália

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pancreatite Necrosante Aguda / Pacotes de Assistência ao Paciente Tipo de estudo: Guideline Limite: Humans Idioma: En Revista: Ann Surg Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Itália