Pancreatic necrosis: Complications and changing trend of treatment

World J Gastrointest Surg. 2019 Apr 27;11(4):198-217. doi: 10.4240/wjgs.v11.i4.198.

Abstract

Incidence of acute pancreatitis seems to be increasing in the Western countries and has been associated with significantly increased morbidity. Nearly 80% of the patients with acute pancreatitis undergo resolution; some develop complications including pancreatic necrosis. Infection of pancreatic necrosis is the leading cause of death in these patients. A significant portion of these patients needs surgical interventions. Traditionally, the "gold standard" procedure has been the open surgical necrosectomy, which is now being completed by the relatively lesser invasive interventions. Minimally invasive surgical (MIS) procedures include endoscopic drainage, percutaneous image-guided catheter drainage, and retroperitoneal drainage. This review article discusses the open and MIS interventions for pancreatic necrosis with each having its own respective benefits and disadvantages are covered.

Keywords: Complications; Minimally invasive surgery; Necrosectomy; Open surgery; Pancreatic necrosis; Review article; Treatment.

Publication types

  • Review