Pancreatic Necrosis: A Challenging Complication of Acute Pancreatitis

Pancreatic necrosis is a complex and challenging complication of severe acute pancreatitis and it occurs in 15 to 25% of patients with acute pancreatitis. It represents one of the most serious complications of severe acute pancreatitis with a mortality rate of 20 to 30%. Majority of necrosis are sterile and can be managed conservatively. However, approximately 30% of pancreatic necrosis develop infection and need an invasive intervention due to aggressive course. A minimal invasive step-up approach using percutaneous catheter drainage or endoscopic transluminal drainage is currently replacing more invasive open necrosectomy. This review provides an overview of patho-physiology, clinical feature and management of pancreatic necrosis.