Interventions for necrotizing pancreatitis: An overview of current approaches

Guru Trikudanathan, Mustafa Arain, Rajeev Attam, Martin L. Freeman

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations

Abstract

The management of necrotizing pancreatitis has undergone a paradigm shift toward minimally invasive techniques for necrosectomy, obviating the need for open necrosectomy in most cases. There is increasing evidence that minimally invasive approaches including a step-up approach that incorporates percutaneous catheter or endoscopic transluminal drainage, followed by video-Assisted retroperitoneal or endoscopic debridement are associated with improved outcomes over traditional open necrosectomy for patients with infected necrosis. A recent international multidisciplinary consensus conference emphasized the superiority of minimally invasive approaches over standard surgical approaches. The success of these techniques depends on concerted efforts of a multidisciplinary team of interventional endoscopists, radiologists, intensivists and surgeons dedicated to the management of severe acute pancreatitis and its complications. This review provides an overview of minimally invasive techniques for management of necrotizing pancreatitis, including indications, timing, advantages and disadvantages.

Original languageEnglish (US)
Pages (from-to)463-475
Number of pages13
JournalExpert Review of Gastroenterology and Hepatology
Volume7
Issue number5
DOIs
StatePublished - Sep 4 2013

Keywords

  • direct endoscopic necrosectomy
  • minimally invasive necrosectomy
  • necrotizing pancreatitis

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