Drainage for Infected Pancreatic Necrosis — Is the Waiting the Hardest Part?

Acute necrotizing pancreatitis, which occurs in up to 30% of episodes of acute pancreatitis, can be a devastating, life-threatening disease. For many years, acute necrotizing pancreatitis (the cause of clinically severe pancreatitis) was managed with open surgical necrosectomy. Surgeons eventually realized that necrosectomy was largely not beneficial for patients with sterile necrosis and that delay in surgery to allow for demarcation of the necrotic process from healthy, viable tissue resulted in better outcomes, including lower surgical mortality.1 The focus then shifted to recognition of and intervention for infected necrosis, as well as determination of the appropriate timing of surgery. Parallel . . .