Management of Necrotizing Pancreatitis

Thomas K Maatman; Nicholas J Zyromski

doi:10.1016/j.yasu.2022.02.010

Management of Necrotizing Pancreatitis

Adv Surg. 2022 Sep;56(1):13-35. doi: 10.1016/j.yasu.2022.02.010.

Authors

Thomas K Maatman¹, Nicholas J Zyromski²

Affiliations

¹ Department of Surgery, Indiana University School of Medicine, 545 Barnhill Dr. EH 519, Indianapolis, IN 46202, USA.
² Department of Surgery, Indiana University School of Medicine, 545 Barnhill Dr. EH 519, Indianapolis, IN 46202, USA. Electronic address: nzyromsk@iupui.edu.

PMID: 36096565
DOI: 10.1016/j.yasu.2022.02.010

Abstract

Necrotizing pancreatitis affects 10% to 15% of all patients with acute pancreatitis. Despite improved understanding of this complex disease, it is still attended by up to 15% mortality. Necrotizing pancreatitis provides the clinical challenges of working in a multi-disciplinary group, determining proper timing for intervention, and identifying appropriate intervention approaches. The step-up approach consists of supportive care initially. When there is documented infected necrosis, treatment begins with antibiotics, progressing to minimally invasive mechanical necrosis intervention, and reserving surgery as the final treatment modality. However, treatment must be tailored to the individual patient. This article provides an overview of necrotizing pancreatitis.

Keywords: Pancreatitis; Pancreatitis acute necrotizing; Practice guideline.

Publication types

Review

MeSH terms

Acute Disease
Drainage
Humans
Necrosis
Pancreatitis, Acute Necrotizing* / diagnosis
Pancreatitis, Acute Necrotizing* / surgery