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Step-up approach for the management of pancreatic necrosis: a review of the literature
  1. Melanie Kay Sion1,
  2. Kimberly A Davis2
  1. 1Surgery, Yale University, New Haven, Connecticut, USA
  2. 2Surgery, Yale School of Medicine, New Haven, Connecticut, USA
  1. Correspondence to Dr Melanie Kay Sion, Surgery, Yale University, New Haven, CT 06520, USA; melanie.sion{at}


Infected necrotizing pancreatitis is a challenging condition to treat because of the profound inflammatory response these patients undergo which can then be exacerbated by interventions. Treatment of this condition has evolved in timing of intervention as well as method of intervention and includes less invasive options for treatment such as percutaneous drainage and endoscopic drainage, in addition to less invasive endoscopic and video-assisted or laparoscopic debridements. The precise optimal treatment strategy for these patients is an ongoing topic of discussion and may be different for each patient as this is a heterogenous condition.

  • acute pancreatitis
  • pancreas
  • severe acute pancreatitis
  • pancreatitis

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  • Contributors MKS reviewed the literature and personally wrote this review article as first author. KAD oversaw MKS's actions, and reviewed and edited this article. KAD is the final author.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

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