Guía informada por la evidencia para el manejo de la enfermedad de Crohn en población adulta: recomendaciones de la Pan American Crohn's and Colitis Organisation (PANCCO)

Fabian Juliao-Baños; Viviana Parra-Izquierdo; Gabriela Abreu; Jordi Alonso Soto; David Andrade Zamora; Oscar Giovanni Avelar Escobar; Carla Bianchi; Hugo Cedron Cheng; Víctor Hugo Fúnez Madrid; Fabio Leonel Gil Parada; Camilo Guillermo Guerrero Velasquez; Paulo G Kotze; Verónica Lockward Grullón; Francisca Martínez Silva; Daniela Méndez Loayza; Juan Paredes Méndez; Carlos Paredes; Ligia Yukie Sassaki; Priscila Saborío-Montero; Rolando Sepúlveda Cortés; Astrid Rausch; Carlos Rettally; Maisa Vallejos; Jairo Amaya-Guío; Rodrigo Pardo Turriago; Yessica León Avendaño; Jesús K Yamamoto-Furusho; Kenneth Ernest-Suarez

doi:10.47892/rgp.2026.463.2299

Authors

Fabian Juliao-Baños Hospital Pablo Tobón Uribe, Medellín, Colombia. https://orcid.org/0000-0002-8610-9925
Viviana Parra-Izquierdo Hospital Internacional de Colombia, Santander, Colombia; Grupo de Inmunología Celular y Molecular (InmuBo), Universidad El Bosque, Colombia. https://orcid.org/0000-0003-2361-1018
Gabriela Abreu Universidad Central de Venezuela, Caracas, Venezuela. https://orcid.org/0009-0009-7428-9330
Jordi Alonso Soto Hospital Clínico Quirúrgico Hermanos Ameijeiras, La Habana, Cuba. https://orcid.org/0000-0002-8396-2752
David Andrade Zamora Hospital José Carrasco Arteaga, Instituto Ecuatoriano de Seguridad Social, Cuenca, Ecuador. https://orcid.org/0009-0007-8860-2119
Oscar Giovanni Avelar Escobar Servicio de Gastroenterología Clínica de Intestino, Instituto Salvadoreño del Seguro Social, San Salvador, El Salvador. https://orcid.org/0000-0002-8077-8618
Carla Bianchi Asociación Española de Montevideo, Uruguay; Sanatorio Cantegril, Punta del Este, Uruguay; Sanatorio Mautone, Punta del Este, Uruguay. https://orcid.org/0009-0008-2608-2258
Hugo Cedron Cheng Clínica Anglo Americana, Lima, Perú. https://orcid.org/0000-0002-9057-829X
Víctor Hugo Fúnez Madrid Torre Xcala, Tegucigalpa, Honduras. https://orcid.org/0009-0008-0291-5892
Fabio Leonel Gil Parada Clínica Universitaria Colombia, Bogotá, Colombia. https://orcid.org/0000-0002-4008-6123
Camilo Guillermo Guerrero Velasquez Gastro Clinic, Managua, Nicaragua. https://orcid.org/0000-0003-3303-5317
Paulo G Kotze Health Sciences Postgraduate Program Pontificia Universidade Catolica do Parana (PUCPR), Curitiba, Brazil. https://orcid.org/0000-0002-9632-6691
Verónica Lockward Grullón Clínica Universitaria Unión Médica, Centro de Excelencia EII, Santiago de los Caballeros, República Dominicana.
Francisca Martínez Silva Hospital de Especialidades Centro Médico Nacional La Raza, IMSS, Ciudad de México, México. https://orcid.org/0000-0002-9243-6906
Daniela Méndez Loayza ENDOCENTER, La Paz, Bolivia; Servicio de Gastroenterología, Hospital Arcoíris, La Paz, Bolivia. https://orcid.org/0000-0002-2454-2969
Juan Paredes Méndez Hospital Guillermo Almenara Irigoyen, Lima, Perú. https://orcid.org/0000-0001-5748-3312
Carlos Paredes Hospital General de Enfermedades, IGSS, Ciudad de Guatemala, Guatemala. https://orcid.org/0000-0001-9868-1577
Ligia Yukie Sassaki Department of Internal Medicine, Medical School, São Paulo State University (Unesp), São Paulo, Brazil. https://orcid.org/0000-0002-7319-8906
Priscila Saborío-Montero Universidad de Costa Rica, San José, Costa Rica; Hospital Dr. Enrique Baltodano, Liberia, Costa Rica. https://orcid.org/0009-0002-4334-1174
Rolando Sepúlveda Cortés Departamento de Medicina Interna, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile; Unidad de Gastroenterología, Hospital Dr. Hernán Henríquez Aravena, Temuco, Chile. https://orcid.org/0000-0002-8405-4035
Astrid Rausch Hospital Británico, Buenos Aires, Argentina. https://orcid.org/0000-0003-4969-7585
Carlos Rettally Unidad de investigación en enfermedades digestivas, Pacífica Salud, Gastroenterólogos Asociados, Ciudad de Panamá, Panamá. https://orcid.org/0000-0002-5025-6819
Maisa Vallejos Hospital de Clínicas, Universidad Nacional de Asunción, Asunción, Paraguay. https://orcid.org/0009-0001-5052-3542
Jairo Amaya-Guío Universidad Nacional de Colombia, Bogotá, Colombia. https://orcid.org/0000-0002-4227-585X
Rodrigo Pardo Turriago Instituto de Investigaciones Clínicas, Universidad Nacional de Colombia, Bogotá, Colombia. https://orcid.org/0000-0001-7411-5853
Yessica León Avendaño Fundación Santa Fe de Bogotá, Bogotá, Colombia.
Jesús K Yamamoto-Furusho Departamento de Gastroenterología, Clínica de Enfermedad Inflamatoria Intestinal, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México. https://orcid.org/0000-0002-5247-5812
Kenneth Ernest-Suarez Universidad de Costa Rica, San José, Costa Rica; División de Gastroenterología, Universidad de Alberta, Edmonton, Alberta, Canadá. https://orcid.org/0000-0001-8360-8190

DOI:

https://doi.org/10.47892/rgp.2026.463.2299

Keywords:

Cholangiopancreatography

Abstract

Introduction: Crohn's disease (CD) is a chronic, relapsing, and progressive inflammatory bowel disease whose incidence and prevalence have steadily increased in Latin America, associated with urbanization and the Westernization of lifestyles. Its heterogeneous course, cumulative structural damage, and impact on quality of life justify regional recommendations to guide the medical, endoscopic, and surgical treatment of affected adults. Objective: To present the evidence-informed recommendations of the Pan American Crohn's and Colitis Organisation (PANCCO) guidelines for the management of CD in Latin American adults. Methodology: The guidelines were developed by adapting and updating the guidelines of the Colombian Association of Gastroenterology (2020), following PAHO/WHO guidelines. An interdisciplinary development group formulated seven clinical questions in PICO format; Four were updated through systematic searches (January 2020–February 2026) in MEDLINE, Embase, Cochrane, and Epistemonikos, with quality assessment using AMSTAR-2, ROBIS, RoB 2.0, and ROBINS-I, and certainty rating and recommendation formulation using the GRADE system. Results: Fifty-two recommendations were formulated, organized around seven clinical questions on relapse prediction, induction and maintenance of remission with conventional therapy, advanced therapy in moderate to severe disease, fistulizing perianal disease, surgical-endoscopic approach, and prevention of postoperative recurrence, supplemented with points of good clinical practice. Conclusions: This guideline compiles the most recent evidence available for the treatment of Crohn's disease in adults, incorporating the use of advanced therapies, the multidisciplinary management of fistulizing perianal disease, and the role of surgery and therapeutic endoscopy, offering a practical framework for clinical decision-making within the context of resources and needs specific to Latin America.

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