title: Minimally invasive intervention for infected necrosis in acute pancreatitis.
abstract: Infected necrosis is the main indication for invasive intervention in acute necrotizing pancreatitis. The 2013 IAP/APA guidelines state that percutaneous catheter drainage should be the first step in the treatment of infected necrosis. In 50-65% of patients, additional necrosectomy is required after catheter drainage, which was traditionally done by open necrosectomy. Driven by the perceived lower complication rate, there is an increasing trend toward minimally invasive percutaneous and endoscopic transluminal necrosectomy. The authors present an overview of current minimally invasive treatment options for necrotizing pancreatitis and review recent developments in clinical studies.
authors.affiliation: Department of Surgery, University Medical Center Utrecht, HP G 04.228, PO BOX 85500, Utrecht, 3508 GA, The Netherlands.
authors.forename: Robbert A
authors.initials: RA
authors.lastname: Hollemans
authors.forename: Sandra
authors.initials: S
authors.lastname: van Brunschot
authors.forename: Olaf J
authors.initials: OJ
authors.lastname: Bakker
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Bollen
authors.forename: Robin
authors.initials: R
authors.lastname: Timmer
authors.forename: Marc G H
authors.initials: MG
authors.lastname: Besselink
authors.forename: Hjalmar C
authors.initials: HC
authors.lastname: van Santvoort
mesh_terms: D000208:Acute Disease; D003131:Combined Modality Therapy / Q000295:instrumentation; D003646:Debridement / Q000295:instrumentation*; D004322:Drainage / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D020706:Laparoscopes; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D010180:Pancreatectomy / Q000295:instrumentation*; D019283:Pancreatitis, Acute Necrotizing / Q000473:pathology* / Q000601:surgery*
keywords: VARD; acute pancreatitis; drainage; endoscopic; laparoscopy; minimally invasive; necrosectomy; necrotizing pancreatitis; surgery