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pres.title = "Management of Acute Pancreatitis";
pres.author = "Postgraduate Clinic";

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// ── HELPERS ──────────────────────────────────────────────────────────────────
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// ── HEADER ROW HELPER ────────────────────────────────────────────────────────
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE
// ═══════════════════════════════════════════════════════════════════════════
titleSlide(
  "Management of\nAcute Pancreatitis",
  "A Postgraduate Clinical Review"
);

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 2 — OVERVIEW / AGENDA
// ═══════════════════════════════════════════════════════════════════════════
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  const topics = [
    "1.  Definition, Epidemiology & Burden",
    "2.  Etiology & Pathophysiology",
    "3.  Clinical Presentation & Diagnosis",
    "4.  Severity Classification (Atlanta / RAC)",
    "5.  Prognostic Scoring Systems",
    "6.  Initial Management & Resuscitation",
    "7.  Nutritional Support",
    "8.  Pharmacotherapy & Antibiotics",
    "9.  ERCP Timing in Gallstone Pancreatitis",
    "10. Local Complications & Interventions",
    "11. Systemic Complications & ICU Care",
    "12. Special Scenarios & Discharge Planning",
  ];
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// ═══════════════════════════════════════════════════════════════════════════
// SECTION 1 DIVIDER
// ═══════════════════════════════════════════════════════════════════════════
sectionDivider("Section 1", "Definition, Epidemiology & Etiology");

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 3 — DEFINITION & EPIDEMIOLOGY
// ═══════════════════════════════════════════════════════════════════════════
contentSlide("Definition & Epidemiology", [
  "## Definition (Revised Atlanta Classification 2012)",
  "Acute inflammatory disease of the pancreas, diagnosed by ≥2 of 3 criteria:",
  "Abdominal pain consistent with AP (acute-onset severe constant epigastric pain, often radiating to the back)",
  "Serum amylase or lipase > 3× upper limit of normal",
  "Characteristic imaging findings on CT / MRI",
  "## Epidemiology",
  "Incidence: 13–45 per 100,000 population per year (increasing globally)",
  "Commonest GI cause of hospital admission in many countries",
  "Mortality: Overall < 3% (mild); severe AP carries 20–30% mortality",
  "80% mild (interstitial edematous); 20% moderate–severe (necrotizing)",
  "## Atlanta Severity Classification",
  "Mild AP: No organ failure, no local or systemic complications",
  "Moderately severe AP: Transient organ failure (<48 h) AND/OR local complications",
  "Severe AP: Persistent organ failure (>48 h) — single or multi-organ",
]);

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 4 — ETIOLOGY (two-col)
// ═══════════════════════════════════════════════════════════════════════════
twoColSlide(
  "Etiology of Acute Pancreatitis",
  "Common Causes (>80%)",
  [
    "Gallstones (biliary) — 40–70%",
    "Alcohol — 25–35%",
    "Idiopathic — 10–15%",
    "Hypertriglyceridemia (TG > 1000 mg/dL)",
    "Post-ERCP — 3–5% of all procedures",
    "Medications (azathioprine, valproate, didanosine, furosemide)",
  ],
  "Less Common / Rare Causes",
  [
    "Hypercalcaemia (hyperparathyroidism)",
    "Pancreatic divisum",
    "Sphincter of Oddi dysfunction",
    "Trauma / blunt abdominal injury",
    "Autoimmune pancreatitis (IgG4-related)",
    "Ampullary / pancreatic tumours",
    "Hereditary: PRSS1, SPINK1, CFTR mutations",
    "Infections: mumps, CMV, HIV",
    "Ischaemia / vasculitis",
  ]
);

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 5 — PATHOPHYSIOLOGY
// ═══════════════════════════════════════════════════════════════════════════
contentSlide("Pathophysiology — Key Mechanisms", [
  "## Acinar Cell Injury (Common Final Pathway)",
  "Premature trypsinogen activation → trypsin overwhelms protective mechanisms",
  "Lysosomal (cathepsin B) and zymogen granule colocalization — critical initiating event",
  "Cytosolic Ca²⁺ rise required for colocalization and NF-κB activation",
  "## Local Cascade",
  "Trypsin activates other zymogens → autodigestion of pancreatic parenchyma",
  "Acinar cell necrosis → neutrophil recruitment → amplified inflammation",
  "Pancreatic microvascular failure → hypoperfusion → necrosis",
  "Interstitial edematous pancreatitis (no necrosis) vs. Necrotizing pancreatitis",
  "## Systemic Cascade (SIRS → MOF)",
  "NF-κB activation → pro-inflammatory cytokines (TNF-α, IL-1β, IL-6, PAF)",
  "Mesenteric lymph bypasses liver → systemic inflammatory spread",
  "Cytokine storm → ARDS, AKI, cardiovascular failure, DIC",
  "Two-peak mortality pattern: early SIRS/MOF vs. late septic complications",
]);

// ═══════════════════════════════════════════════════════════════════════════
// SECTION 2 DIVIDER
// ═══════════════════════════════════════════════════════════════════════════
sectionDivider("Section 2", "Clinical Presentation, Diagnosis & Severity Scoring");

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 6 — CLINICAL FEATURES & DIAGNOSIS
// ═══════════════════════════════════════════════════════════════════════════
twoColSlide(
  "Clinical Presentation & Diagnosis",
  "Clinical Features",
  [
    "Severe, constant epigastric pain — radiation to back",
    "Nausea, vomiting (common)",
    "Low-grade fever",
    "Tachycardia, tachypnea, hypotension (severe)",
    "Abdominal guarding / peritonism",
    "Cullen's sign — periumbilical ecchymosis",
    "Grey Turner's sign — flank ecchymosis",
    "Tetany (hypocalcaemia)",
    "Jaundice (if biliary aetiology)",
  ],
  "Investigations",
  [
    "Serum lipase — more specific (preferred); >3× ULN",
    "Serum amylase — peaks 2–12 h; normalises by 3–5 days",
    "LFTs, bilirubin, ALP — biliary aetiology",
    "FBC, CRP (>150 mg/L at 48 h → severe)",
    "BUN/creatinine, blood glucose, calcium",
    "ABG — if respiratory compromise",
    "USS abdomen — gallstones, CBD dilation",
    "CECT — if diagnosis uncertain OR at 48–72 h if severe",
    "MRCP — if suspected choledocholithiasis",
  ]
);

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 7 — CECT SCORING
// ═══════════════════════════════════════════════════════════════════════════
{
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    fontSize: 22, bold: true, color: C.white, fontFace: "Calibri", valign: "middle",
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    [cellC("C"), cell("Peripancreatic fat inflammation"), cellC("2")],
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    [cellC("4–6"), cell("Moderate"), cellC("35%"), cellC("6%")],
    [cellC("7–10", C.red, C.white), cell("Severe", C.red, C.white), cellC("92%", C.red, C.white), cellC("17%", C.red, C.white)],
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    border: { type: "solid", pt: 0.5, color: "CCCCCC" } });
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 8 — SEVERITY SCORING (Ranson & BISAP)
// ═══════════════════════════════════════════════════════════════════════════
{
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  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0.85, w: "100%", h: 0.06, fill: { color: C.gold } });
  sl.addText("Prognostic Scoring: Ranson Criteria & BISAP", {
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    fontSize: 22, bold: true, color: C.white, fontFace: "Calibri", valign: "middle",
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  // Ranson
  sl.addText("Ranson Criteria", { x: 0.3, y: 1.0, w: 7, h: 0.4, fontSize: 14, bold: true, color: C.teal, fontFace: "Calibri" });
  sl.addTable([
    [hdr("On Admission", 1), hdr("At 48 Hours", 1)],
    [cell("Age > 55 years"), cell("Haematocrit fall > 10%")],
    [cell("WBC > 16,000/mm³"), cell("BUN rise > 5 mg/dL")],
    [cell("Blood glucose > 200 mg/dL"), cell("Serum Ca²⁺ < 8 mg/dL")],
    [cell("LDH > 350 IU/L"), cell("PaO₂ < 60 mmHg")],
    [cell("AST > 250 IU/L"), cell("Base deficit > 4 mEq/L")],
    [cell(""), cell("Fluid sequestration > 6 L")],
  ], { x: 0.3, y: 1.45, w: 7.5, h: 3.2, colW: [3.7, 3.8], fontSize: 12, fontFace: "Calibri",
    border: { type: "solid", pt: 0.5, color: "CCCCCC" } });

  sl.addText("Score ≥3 → severe disease (mortality 10–15%); Score ≥5 → mortality > 40%", {
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  // BISAP
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  sl.addTable([
    [hdr("BISAP Parameter", 1)],
    [cell("B — BUN > 25 mg/dL")],
    [cell("I — Impaired mental status")],
    [cell("S — SIRS criteria ≥2")],
    [cell("A — Age > 60 years")],
    [cell("P — Pleural effusion on imaging")],
  ], { x: 8.3, y: 1.45, w: 4.9, h: 2.5, colW: [4.9], fontSize: 12, fontFace: "Calibri",
    border: { type: "solid", pt: 0.5, color: "CCCCCC" } });

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    x: 8.3, y: 4.0, w: 4.9, h: 0.4, fontSize: 11.5, italic: true, color: C.grey, fontFace: "Calibri",
  });

  sl.addShape(pres.ShapeType.rect, { x: 0.3, y: 5.3, w: 12.5, h: 0.06, fill: { color: C.gold } });
  sl.addText("APACHE II ≥8 also identifies severe AP with ≥25% mortality. Best used in ICU settings.", {
    x: 0.3, y: 5.5, w: 12.5, h: 0.4, fontSize: 12, bold: true, color: C.teal, fontFace: "Calibri",
  });
}

// ═══════════════════════════════════════════════════════════════════════════
// SECTION 3 DIVIDER
// ═══════════════════════════════════════════════════════════════════════════
sectionDivider("Section 3", "Initial Management & Resuscitation");

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 9 — INITIAL MANAGEMENT
// ═══════════════════════════════════════════════════════════════════════════
contentSlide("Initial Management — First 24 Hours", [
  "## Admission & Triage",
  "All patients with suspected AP should be admitted to hospital",
  "Mild AP → General ward; Moderate–Severe → HDU/ICU",
  "Reassess at 24 h and 48 h — severity can escalate",
  "## IV Fluid Resuscitation (Goal-Directed)",
  "Aggressive IV fluid resuscitation — cornerstone of early management",
  "Preferred: Lactated Ringer's (LR) — reduces systemic inflammation vs. normal saline (ACG 2024 / IAP 2025)",
  "Rate: 250–500 mL/h titrated to clinical response (HR, MAP, urine output)",
  "Target: UO > 0.5 mL/kg/h; BUN decrease; haematocrit 35–44%",
  "Avoid: Over-resuscitation → abdominal compartment syndrome",
  "## Pain Management",
  "Priority — early adequate analgesia",
  "IV NSAIDs (e.g. metamizole 2 g/8 h IV) for mild pain",
  "Opioid analgesia for severe pain: buprenorphine, pentazocine, pethidine",
  "! Morphine avoided — risk of sphincter of Oddi spasm",
  "Thoracic epidural analgesia may reduce complications in severe AP",
]);

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 10 — NUTRITION
// ═══════════════════════════════════════════════════════════════════════════
twoColSlide(
  "Nutritional Support in Acute Pancreatitis",
  "Key Principles",
  [
    "Gut rest is OUTDATED — early enteral nutrition is preferred",
    "Enteral route maintains gut barrier, reduces bacterial translocation",
    "Reduces infectious complications and mortality (vs. TPN)",
    "Start EN within 24–48 h if tolerated",
    "Mild AP — resume oral diet (low-fat) as soon as pain improves & appetite returns",
    "Severe AP — early nasojejunal (NJ) or nasogastric (NG) tube feeding",
    "NJ vs NG — both are acceptable (IAP/APA 2025)",
  ],
  "Parenteral Nutrition (TPN)",
  [
    "Reserve TPN only when enteral route is not feasible",
    "Enteral feeding within 72 h of onset is preferred over TPN",
    "Indications for TPN:",
    "  ↳ Ileus preventing enteral feeding",
    "  ↳ Fistulas preventing enteral access",
    "  ↳ Bowel obstruction",
    "Monitor for hyperglycaemia — tight glycaemic control",
    "Supplemental glutamine may be considered in TPN",
  ]
);

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 11 — ANTIBIOTICS & PHARMACOTHERAPY
// ═══════════════════════════════════════════════════════════════════════════
contentSlide("Antibiotics & Pharmacotherapy", [
  "## Antibiotics — Current Evidence (ACG 2024 / IAP 2025)",
  "! Prophylactic antibiotics are NOT recommended in sterile AP or sterile necrosis",
  "Multiple RCTs and meta-analyses showed no benefit from prophylactic antibiotics",
  "Antibiotics indicated ONLY when:",
  "  ↳ Infected necrotizing pancreatitis (confirmed or strongly suspected)",
  "  ↳ Extra-pancreatic infection (cholangitis, pneumonia, UTI, bacteraemia)",
  "## Antibiotic Choice for Infected Necrosis",
  "Carbapenems (imipenem/meropenem) — excellent pancreatic penetration",
  "Fluoroquinolones (ciprofloxacin) + metronidazole — alternative",
  "Duration: guided by clinical response and source control",
  "## Other Pharmacotherapy",
  "Antifungals: consider if prolonged antibiotics, immunosuppression, or fungal infection suspected",
  "Somatostatin / octreotide — evidence does NOT support routine use",
  "Protease inhibitors (gabexate, nafamostat) — insufficient evidence for routine use",
  "Proton pump inhibitors — use only for stress ulcer prophylaxis in critically ill",
]);

// ═══════════════════════════════════════════════════════════════════════════
// SECTION 4 DIVIDER
// ═══════════════════════════════════════════════════════════════════════════
sectionDivider("Section 4", "Biliary Pancreatitis, Local Complications & Interventions");

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 12 — ERCP IN BILIARY PANCREATITIS
// ═══════════════════════════════════════════════════════════════════════════
contentSlide("ERCP Timing in Gallstone (Biliary) Pancreatitis", [
  "## Indications for Urgent ERCP (within 24 h)",
  "Acute cholangitis complicating gallstone pancreatitis — URGENT ERCP",
  "Obstructive jaundice with CBD stone on imaging — ERCP within 24–48 h",
  "## Mild Biliary AP Without Cholangitis",
  "Urgent ERCP does NOT reduce complications — not routinely recommended",
  "However, persistent biliary obstruction warrants early ERCP",
  "## Cholecystectomy",
  "Same-admission laparoscopic cholecystectomy for mild biliary AP (reduces recurrence)",
  "For severe AP — defer cholecystectomy until inflammation resolves (≥6 weeks)",
  "Cholecystectomy should be performed before discharge in mild AP (ACG 2024)",
  "## Prevention of Post-ERCP Pancreatitis",
  "Rectal indomethacin (100 mg) — reduces post-ERCP pancreatitis risk",
  "Prophylactic pancreatic stent placement — high-risk patients",
  "Wire-guided cannulation technique preferred over contrast injection",
]);

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 13 — LOCAL COMPLICATIONS TABLE
// ═══════════════════════════════════════════════════════════════════════════
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    "Pseudocysts develop after 4 weeks; asymptomatic pseudocysts → observe; symptomatic → drainage (endoscopic preferred)",
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 14 — MANAGEMENT OF NECROSIS & INTERVENTION
// ═══════════════════════════════════════════════════════════════════════════
contentSlide("Management of Pancreatic Necrosis & Infected Collections", [
  "## Principle: Step-Up Approach (IAP/APA 2025 / ACG 2024)",
  "Delay intervention as long as possible — preferably ≥4 weeks (for WON to mature)",
  "Conservative management with antibiotics for 2–4 weeks before intervention",
  "## Step 1 — Percutaneous/Endoscopic Drainage",
  "EUS-guided transmural drainage (cystogastrostomy / cystoduodenostomy) — PREFERRED for WON",
  "Percutaneous catheter drainage — if WON not accessible endoscopically",
  "Lumen-apposing metal stents (LAMS) — increasingly used for EUS drainage",
  "## Step 2 — Minimally Invasive Necrosectomy",
  "Video-assisted retroperitoneal debridement (VARD)",
  "Endoscopic necrosectomy (direct endoscopy through stent tract)",
  "Repeated lavage sessions often required for infected WON",
  "## Step 3 — Open Surgical Necrosectomy (reserved)",
  "Only if minimally invasive approaches fail",
  "High morbidity and mortality — last resort",
  "Open necrosectomy: minimal access retroperitoneal, laparoscopic, or open laparotomy",
]);

// ═══════════════════════════════════════════════════════════════════════════
// SECTION 5 DIVIDER
// ═══════════════════════════════════════════════════════════════════════════
sectionDivider("Section 5", "Systemic Complications, ICU Care & Special Scenarios");

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 15 — SYSTEMIC COMPLICATIONS
// ═══════════════════════════════════════════════════════════════════════════
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  "Major Systemic Complications",
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    "ARDS / ALI — most common organ failure",
    "  ↳ Mechanical ventilation, lung-protective strategy",
    "Acute Kidney Injury (AKI)",
    "  ↳ Aggressive fluid resuscitation, avoid nephrotoxins",
    "  ↳ RRT if persistent oliguria/anuria",
    "Cardiovascular failure / shock",
    "  ↳ Vasopressors (noradrenaline first-line)",
    "Disseminated Intravascular Coagulation (DIC)",
    "Hypocalcaemia — calcium gluconate IV",
    "Hyperglycaemia — insulin infusion (target 7.8–10 mmol/L)",
    "Paralytic ileus",
    "Splenic / portal vein thrombosis",
  ],
  "ICU Care Priorities",
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    "Early organ support — do not delay ICU transfer",
    "Continuous monitoring: A-line, CVP, urinary catheter",
    "SOFA score monitoring — serial assessment",
    "Modified fluid resuscitation after first 48 h — avoid fluid overload",
    "DVT prophylaxis (LMWH) once haemorrhagic risk assessed",
    "Stress ulcer prophylaxis (PPI / H₂ blocker)",
    "Enteral nutrition via NGT/NJT",
    "Abdominal compartment syndrome:",
    "  ↳ Bladder pressure monitoring",
    "  ↳ Decompressive laparotomy if IAP > 20 mmHg + new organ failure",
  ]
);

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 16 — VASCULAR & HAEMORRHAGIC COMPLICATIONS
// ═══════════════════════════════════════════════════════════════════════════
contentSlide("Vascular & Haemorrhagic Complications", [
  "## Pseudoaneurysm (PA)",
  "Complicates 1–2% of severe AP — erosion of peripancreatic vessels",
  "Splenic artery most common (65%); also gastroduodenal, pancreaticoduodenal arteries",
  "Presentation: sudden haematocrit drop, expanding collection, haemobilia",
  "Diagnosis: CECT with angiography",
  "Management: Angioembolisation — first-line; surgery if embolisation fails",
  "## Splenic / Portal / Mesenteric Vein Thrombosis",
  "Complicates 1–24% of severe AP",
  "Splenic vein thrombosis most common → left-sided (segmental) portal hypertension",
  "Anticoagulation for symptomatic portal vein thrombosis",
  "## Haemorrhagic Pancreatitis",
  "Haemorrhage into retroperitoneum or peritoneal cavity",
  "Massive haemorrhage: embolisation or surgical control",
  "Requires surgical assessment if haemodynamically unstable",
]);

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 17 — SPECIAL SCENARIOS
// ═══════════════════════════════════════════════════════════════════════════
twoColSlide(
  "Special Clinical Scenarios",
  "Hypertriglyceridaemia-Induced AP",
  [
    "TG > 1000 mg/dL — significant risk; >2000 mg/dL — severe",
    "Management:",
    "  ↳ Insulin infusion (activates lipoprotein lipase)",
    "  ↳ Heparin infusion (short-term, controversial)",
    "  ↳ Plasmapheresis/apheresis — rapid TG reduction",
    "  ↳ Restrict fat intake once feeding resumes",
    "Long-term: fibrates (gemfibrozil), omega-3s, diet",
    "Avoid oestrogen, thiazides, retinoids (precipitants)",
  ],
  "Pregnancy & Recurrent AP",
  [
    "Biliary AP most common in pregnancy",
    "MRCP preferred (avoid radiation)",
    "ERCP + sphincterotomy if choledocholithiasis",
    "Cholecystectomy deferred to second trimester or post-partum",
    "LR fluid preferred — safe in pregnancy",
    "",
    "Recurrent Acute Pancreatitis:",
    "  ↳ Investigate for genetic causes (PRSS1, SPINK1, CFTR)",
    "  ↳ Autoimmune: IgG4, ANA, serology",
    "  ↳ MRCP / EUS for structural lesions",
    "  ↳ Risk of progression to chronic pancreatitis",
  ]
);

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 18 — DISCHARGE & FOLLOW-UP
// ═══════════════════════════════════════════════════════════════════════════
contentSlide("Discharge Criteria & Follow-Up", [
  "## Discharge Criteria (Mild AP)",
  "Oral intake tolerated (low-fat diet) without pain",
  "Significant improvement in pain and inflammatory markers",
  "Absence of complications requiring continued hospital care",
  "Afebrile and haemodynamically stable",
  "## Cholecystectomy Timing",
  "Mild biliary AP → same admission or within 2 weeks of discharge (reduces recurrence from 30% to <1%)",
  "Severe/necrotising AP → defer until resolution (minimum 6–8 weeks)",
  "## Follow-Up",
  "4–6 week review: repeat imaging (USS/CT) for fluid collections",
  "Assess for exocrine pancreatic insufficiency: steatorrhoea, weight loss → PERT (pancreatic enzyme replacement)",
  "Screen for new-onset diabetes mellitus (Type 3c diabetes)",
  "Counsel on alcohol cessation, dietary modification, weight management",
  "## Long-Term Risk",
  "Recurrence risk: 20–35% if underlying cause not addressed",
  "Progression to chronic pancreatitis in 10–20% (especially alcohol-related)",
]);

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 19 — MANAGEMENT ALGORITHM
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 20 — KEY TAKEAWAYS
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 21 — REFERENCES
// ═══════════════════════════════════════════════════════════════════════════
contentSlide("References & Guidelines", [
  "## Clinical Guidelines",
  "IAP/APA/EPC/IPC/JPS Working Group. Revised Guidelines on Acute Pancreatitis 2025. Pancreatology. 2025 Sep. [PMID: 40651900]",
  "Tenner S, Vege SS, Sheth SG, et al. American College of Gastroenterology Guidelines: Management of Acute Pancreatitis. Am J Gastroenterol. 2024. [PMID: 38857482]",
  "UK Working Party on Acute Pancreatitis. UK Guidelines for the Management of Acute Pancreatitis. Gut. 2005;54(Suppl III):1–9.",
  "Banks PA et al. Classification of acute pancreatitis — 2012: revision of the Atlanta classification. Gut. 2013;62(1):102–11.",
  "## Textbooks",
  "Schwartz's Principles of Surgery, 11th Edition — Chapter 33: Pancreas",
  "Maingot's Abdominal Operations, 12th Edition — Chapter 55: Complications of Acute Pancreatitis",
  "Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 11th Edition",
  "Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice",
  "## Scoring Systems",
  "Ranson JH. Etiological and prognostic factors in human acute pancreatitis. Am J Gastroenterol. 1979.",
  "Wu BU et al. The early prediction of mortality in acute pancreatitis (BISAP). Gut. 2008;57(12):1608–14.",
  "Balthazar EJ et al. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990.",
]);

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