Expert panel weighs evidence for genetic testing, cholecystectomy, and ERCP in patients with unexplained acute pancreatitis amid limited guideline direction.
Idiopathic acute pancreatitis accounts for about 18% of global cases, with genetic testing and selective surgery reducing recurrence risk.
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Genetic testing can identify pathogenic variants in over 50% of younger patients with idiopathic acute pancreatitis or recurrent pancreatitis.
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Empiric cholecystectomy may lower recurrence rates, especially when occult biliary disease is detected, despite mixed evidence.
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Routine ERCP is not recommended for idiopathic acute pancreatitis due to risks of pancreatitis and mortality associated with the procedure.
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Current guidelines on genetic testing and management of idiopathic acute pancreatitis vary between the American College of Gastroenterology and the International Association of Pancreatology.
