4. Best test

5. Can be done at 24 hrs, can be repeated

6. Ranson’s Criteria (1974!)

7. Needs to be done at 24 and 48 hrs

8. Balthazar’s (CT scan criteria)

9. Glascow

17. may lead to life threatening conditions .

18. SAP usually develops when part of the pancreas become necrotic and many complications are associated with the presence of this dead pancreatic tissue.

19. It requires intensive and aggressive management.

25. Limited to the human studies without language restrictions.

27. SAP was diagnosed with contrast enhanced CT scan and any of the following : APACHE II, Imrie classification and increased C-reactive protein levels > 120 mg /Dl.

28. Necrosis by CT scan.

29. Prophylactic antibiotics were administered IV .

30. Defined length of antibiotics treatment.

31. M and M measured objectively .

34. Each articles scrutinized to meet the criteria.

35. Data abstracted independently by each reviewer using a standardized data collection to increase the uniformity of data and to reduce the reporting bias.

38. < 3 low study quality.

40. The effect measures estimated were relative risk (RR) for dichotomous data, which we report with 95% confidence intervals (CIs).

41. The RR indicates the risk of an individual who received prophylactic antibiotics developing a wound infection compared with the risk of an individual not receiving prophylactic antibiotics.

44. A total of 253 pts were randomized to the antibiotic prophylaxis group and 249 were randomized to the placebo arm.

45. Age ranged from 43 to 59 yrs.

46. 60 % alcoholic , 24% biliary , and 20 % other causes.

47. Duration of antibiotics treatment ranged from 5 to 21 days .

65. Systemic review and meta-analysis until May 2008 was used.

66. Systematic search of MEDLINE ,EMBASE and Cochrane central register of controlled trial used.

69. Results were subjected to sensitivity analysis to determine heterogeneity among studies.

70. 502 patients from 8 studies.