title: Necrotizing pancreatitis: A review of the interventions.
abstract: Acute pancreatitis may have a wide range of severity, from a clinically self-limiting to a quickly fatal course. Necrotizing pancreatitis (NP) is the most dreadful evolution associated to a poor prognosis: mortality is approximately 15% and up to 30-39% in case of infected necrosis, which is the major cause of death. Intervention is generally required for infected pancreatic necrosis and less commonly in patients with sterile necrosis who are symptomatic (gastric or duodenal outlet or biliary obstruction). Traditionally the most widely used approach to infected necrosis has been open surgical necrosectomy, but it is burdened by high morbidity (34-95%) and mortality (11-39%) rates. In the last two decades the treatment of NP has significantly evolved from open surgery towards minimally invasive techniques (percutaneous catheter drainage, per-oral endoscopic, laparoscopy and rigid retroperitoneal videoscopy). The objective of this review is to summarize the current state of the art of the management of NP and to clarify some aspects about its diagnosis and treatment.
authors.affiliation: General Surgery, "San Giovanni Battista Hospital", AUSL Umbria 2, Via M. Arcamone, 06034, Foligno, Perugia, Italy; University of Perugia, PhD School in Biotechnologies, Italy. Electronic address: walterbugiantella@alice.it.
authors.forename: Walter
authors.initials: W
authors.lastname: Bugiantella
authors.affiliation: General Surgery, "San Giovanni Battista Hospital", AUSL Umbria 2, Via M. Arcamone, 06034, Foligno, Perugia, Italy; University of Perugia, Department of Surgical and Biomedical Sciences, Via G. Dottori, 06100, Perugia, Italy. Electronic address: rondellif@hotmail.com.
authors.forename: Fabio
authors.initials: F
authors.lastname: Rondelli
authors.affiliation: General Surgery, "San Giovanni Battista Hospital", AUSL Umbria 2, Via M. Arcamone, 06034, Foligno, Perugia, Italy. Electronic address: bonimarce@tiscali.it.
authors.forename: Marcello
authors.initials: M
authors.lastname: Boni
authors.affiliation: General Surgery, "San Giovanni Battista Hospital", AUSL Umbria 2, Via M. Arcamone, 06034, Foligno, Perugia, Italy. Electronic address: paolo.stella@uslumbria2.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Stella
authors.affiliation: General and Specialized Surgery, "Santa Maria" Hospital, Via T. Di Joannuccio, 05100, Terni, Italy. Electronic address: apolis74@yahoo.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Polistena
authors.affiliation: General and Specialized Surgery, "Santa Maria" Hospital, Via T. Di Joannuccio, 05100, Terni, Italy. Electronic address: alessandrosanguinetti@gmail.com.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sanguinetti
authors.affiliation: General and Specialized Surgery, "Santa Maria" Hospital, Via T. Di Joannuccio, 05100, Terni, Italy. Electronic address: nicolaavenia@libero.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
mesh_terms: D003646:Debridement; D004322:Drainage / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D010179:Pancreas / Q000601:surgery; D019283:Pancreatitis, Acute Necrotizing / Q000145:classification / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications
keywords: Endoscopic; Necrosectomy; Necrotizing pancreatitis; Review; Surgery