Revisiting the timing of intervention in necrotising pancreatitis

Abstract

Acute pancreatitis is a leading cause of emergency hospitalisation, with its incidence and aetiology varying geographically [1]. While most patients pursue a mild course, approximately 20% develop acute necrotising pancreatitis (ANP), with some progressing to secondary infected necrotising pancreatitis (INP), often associated with organ failure, and consequent high morbidity and mortality [2, 3]. Persistent organ failure (POF) for 48 h or more, which defines severe acute pancreatitis as per the revised Atlanta classification [3], remains a major clinical challenge, frequently requiring intensive care support with a commensurate strain on healthcare resources. Much effort has been expended into trying to modify disease progression in patients with INP with the ultimate aspiration of improving outcome.