Compliance with evidence-based clinical guidelines in the management of acute biliary pancreatitis: the MANCTRA-1 study protocol

Mauro Podda*, Gianluca Pellino, Federico Coccolini, Chiara Gerardi, Salomone Di Saverio, Francesco Pata, Benedetto Ielpo, Francesco Virdis, Dimitrios Damaskos, Stavros Gourgiotis, Gaetano Poillucci, Daniela Pacella, Kumar Jayant, Ferdinando Agresta, Massimo Sartelli, Ari Leppaniemi, Yoram Kluger, Fausto Catena, Adolfo Pisanu

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)


Despite existing evidence-based practice guidelines for the management of biliary acute pancreatitis (AP), the clinical compliance with recommendations is overall poor. Studies in this field have identified significant discrepancies between evidence-based recommendations and daily clinical practice. The most commonly reported gaps between clinical practice and AP guidelines include the indications for CT scan, need and timing of artificial nutritional support, indications for antibiotics, and surgical/endoscopic management of biliary AP. The MANCTRA-1 (coMpliAnce with evideNce-based cliniCal guidelines in the managemenT of acute biliaRy pancreAtitis) study is aiming to identify the areas for quality improvement that will require new implementation strategies. The study primary objective is to evaluate which items of the current AP guidelines are commonly disregarded and if they correlate with negative clinical outcomes according to the different clinical presentations of the disease. We attempt to summarize the main areas of sub-optimal care due to the lack of compliance with current guidelines to provide the basis for introducing a number of bundles in AP patients’ management to be implemented during the next years. The MANCTRA-1 study is an international multicenter, retrospective cohort study with the purpose to assess the outcomes of patients admitted to hospital with a diagnosis of biliary AP and the compliance of surgeons worldwide to the most up-to-dated international guidelines on biliary AP. ClinicalTrials.Gov ID Number: NCT04747990, Date: February 23, 2021. Protocol Version V2.2.

Original languageEnglish
Pages (from-to)1757-1765
Number of pages9
JournalUpdates in Surgery
Issue number5
Publication statusPublished - Oct 2021


  • Acute pancreatitis
  • Biliary pancreatitis
  • Global surgery
  • Guidelines compliance
  • Study protocol
  • Sub-optimal care


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