title: Practical strategies for case selection in minimally invasive necrosectomy.
abstract: BACKGROUND
  Minimally invasive necrosectomy is an umbrella term encapsulating the retroperitoneal, endoscopic and laparoscopic approaches. However, current evidence is unclear in terms of which approach to select in any particular setting.
  
  
  RESULTS
  This leading article provides a pragmatic guide to approach selection in treating pancreatic necrosis with particular reference to the use of minimally invasive approaches. Current evidence in relation to timing of surgery, use of fine-needle aspiration and detailed imaging by magnetic resonance scanning is incorporated into a modern treatment algorithm.
  
  
  CONCLUSIONS
  The era of minimally invasive necrosectomy has arrived. In the absence of randomised trial evidence, the keys to contemporary management of pancreatic necrosis are good multidisciplinary care, adequate high-quality imaging and careful consideration of all available treatment options including traditional open approaches.
authors.affiliation: Hepatobiliary Surgical Unit, Manchester Royal Infirmary, Manchester, UK.
authors.forename: Benoy Idicula
authors.initials: BI
authors.lastname: Babu
authors.forename: Ajith K
authors.initials: AK
authors.lastname: Siriwardena
mesh_terms: D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009336:Necrosis / Q000601:surgery; D010179:Pancreas / Q000473:pathology*; D010182:Pancreatic Diseases / Q000601:surgery*; D019283:Pancreatitis, Acute Necrotizing / Q000601:surgery