Othman AAA. Colloids in acute pancreatitis: Microcirculatory advantage or inflammatory mirage. World J Gastrointest Surg 2026; 18(8): 115464 [DOI: 10.4240/wjgs.115464]
Corresponding Author of This Article
Amira Ahmed Abdelrahman Othman, MD, Department of Internal Medicine, Suez University, Cairo-Suez Road, Suez 43511, Egypt. amira.othman@med.suezuni.edu.eg
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2026; 18(8): 115464 Published online Aug 27, 2026. doi: 10.4240/wjgs.115464
Colloids in acute pancreatitis: Microcirculatory advantage or inflammatory mirage
Amira Ahmed Abdelrahman Othman
Amira Ahmed Abdelrahman Othman, Department of Internal Medicine, Suez University, Suez 43511, Egypt
Author contributions: Othman AAA conceptualized the editorial theme, reviewed the relevant literature, and wrote the manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Corresponding author: Amira Ahmed Abdelrahman Othman, MD, Department of Internal Medicine, Suez University, Cairo-Suez Road, Suez 43511, Egypt. amira.othman@med.suezuni.edu.eg
Received: October 17, 2025 Revised: November 27, 2025 Accepted: January 4, 2026 Published online: August 27, 2026 Processing time: 303 Days and 13.2 Hours
Core Tip
Core Tip: Fluid resuscitation remains the cornerstone of acute pancreatitis care; however, the ideal composition remains unsettled. A recent randomized trial comparing Dextran 40 Plus Ringer’s lactate vs Ringer’s lactate alone demonstrated lower C-reactive protein but no difference in systemic inflammation or organ failure. This editorial explores why the apparent biochemical benefit may not translate into clinical improvement, highlighting the intricate interplay between microcirculation, endothelial integrity, and inflammatory signaling. The piece highlights how this study refines, not resolves, the colloid debate, underscoring the need for individualized, goal-directed hydration strategies guided by hemodynamic and perfusion markers rather than fixed formulas.
