Pancreatology in focus at UEG Week 2025: key messages, new algorithms and guidelines

Abstract

UEG Week 2025 in Berlin brought together more than 12,000 specialists and focused on the pancreas. Managing patients with pancreatic pathology requires precision, speed and teamwork. Key updates were presented in the pancreatology section: global initiatives to create unified guidelines for cystic neoplasms (pancreatic cystic neoplasms — PCN) were presented, which should reduce the variability of patient management from the initial stage of medical care to expert centers. The capabilities of artificial intelligence in imaging studies (computed tomography/magnetic resonance imaging and endoscopic ultrasound,) for screening for pancreatic cancer and real-time detection of pancreatic lesions were demonstrated. Practical messages for acute pancreatitis are provided: the presence of signs of a systemic inflammatory response on admission and after 48 hours, together with the determination of interleukin-6/C-reactive protein levels. Data supporting the use of opioids in acute pancreatitis are presented; they have been proven to be safe and effective with clear de-escalation, cyclooxygenase-2 can act as adjuvants for analgesia, and epidural analgesia can be an option for managing severe patients. Prophylactic anticoagulation in moderately severe/severe acute pancreatitis reduces complications and mortality; however, isolated splenic vein thrombosis does not require routine anticoagulant therapy. In the management of patients with chronic pancreatitis, emphasis is placed on the diagnosis and treatment of exocrine pancreatic insufficiency: the decision is based not on a single faecal elastase test, but on a combination of symptoms, nutritional markers and clinical context. Enzyme replacement therapy and dietary support are the standard treatment for exocrine pancreatic insufficiency. The nutritional status of patients with pancreatic cancer can be improved with fish oil, exercise, and enzyme replacement therapy; these recommendations help prevent the onset and progression of sarcopenia.