Timing, approach, and treatment strategies for infected pancreatic necrosis: a narrative review

ancreatic necrosis occurs in approximately 15% to 20% of patients with acute pancreatitis (AP); 1/3 of patients are diagnosed with infected pancreatic necrosis (IPN), which has a mortality rate of 30%. It is the chief reason for the second “death peak” of AP patients in the later stage of the disease. [1] As one of the most vital treatment methods for IPN, pancreatic necrosectomy has developed rapidly in the past 30 years, including improvements and breakthroughs in surgical timing, approach, and strategies, and a significant reduction in postoperative mortality from the initial 30% to 40%. In particular, with the innovation of laparoscopic and endoscopic tech- niques, pancreatic surgeons have more choices in the face of IPN. Currently, how to optimize treatment and maximize the benefits for IPN patients has become a topic of great concern and controversy in the treatment of IPN.