Necrotizing pancreatitis: A review for the acute care surgeon

Am J Surg. 2021 May;221(5):927-934. doi: 10.1016/j.amjsurg.2020.08.027. Epub 2020 Aug 26.


Background: Necrotizing pancreatitis is a common condition with high mortality; the acute care surgeon is frequently consulted for management recommendations. Furthermore, there has been substantial change in the timing, approach, and frequency of surgical intervention for this group of patients.

Methods: In this article we summarize key clinical and research developments regarding necrotizing pancreatitis, including current recommendations for treatment of patients requiring intensive care and those with common complications. Articles from all years were considered to provide proper historical context, and most recent management recommendations are identified.

Results: Epidemiology, diagnosis, treatment in the acute phase, and complications (both short-term and long-term) are discussed. Images of surgical interventions are included from our institutional experience.

Conclusion: Necrotizing pancreatitis management remains heavily based on clinical judgement, although technological advances and clinical trials have made decision making more straightforward.

Keywords: Necrosis; Pancreas; Pancreatitis.

Publication types

  • Review

MeSH terms

  • Humans
  • Pancreatitis, Acute Necrotizing / diagnosis
  • Pancreatitis, Acute Necrotizing / diagnostic imaging
  • Pancreatitis, Acute Necrotizing / surgery*
  • Tomography, X-Ray Computed