Toolkit to Promote Collaboration Between Surgeons and Anesthesiologists: Addressing Common Barriers to Perioperative Teamwork.

Acute pancreatitis (AP) is characterized by an abrupt onset of acute inflammation and is associated with severe abdominal pain. Globally, AP affects approximately 34 patients per 100,000 population annually, with even higher rates reported in certain regions. AP can lead to significant short- and long-term complications, such as recurrent episodes of AP, endocrine and exocrine insufficiency [diabetes mellitus (DM) and exocrine pancreatic dysfunction (EPD), respectively], micronutrient deficiencies, dysbiosis and malnutrition. Pancreatic inflammation triggers a cascade of local and systemic changes resulting in organ dysfunction and persistent symptoms (particularly pain). The prior paradigm was that patients fully recover after an AP episode; however, data from the Post-Acute Pancreatitis Pancreatic Exocrine Insufficiency (PAPPEI) study (and others) have demonstrated persistent pancreatic dysfunction (both DM and EPD) and gastrointestinal (GI) symptoms. Considering these persistent abnormalities, there is interest to understand the potential interaction and impact of dietary patterns on AP. Dietary exposure, specifically an inflammatory dietary pattern, is linked with chronic inflammatory-based conditions such as cancer, cardiovascular disease, diabetes, and neurodegenerative diseases. Interestingly, the inflammatory characteristics of the diet have been linked to the prevalence of general abdominal pain in European and US populations. Abdominal pain is one of the most commonly reported GI symptoms in those with acute and chronic pancreatitis contributing to poor quality of life. Currently, limited data exist regarding dietary patterns in AP. Reported findings from a previous observational study from our group suggest an omnivore predominant dietary pattern may contribute to the severity of AP. Alcohol, another dietary exposure, has been well-recognized as a risk factor for AP and risk of multisystem organ failure. Collectively dietary characteristics are commonly linked to the inflammatory potential of the diet, such as red and processed meat intake, suggesting a biologically plausible role in the inflammatory cascade due to oxidative stress and resolution seen in AP.