Current Concepts in Severe Acute and Necrotizing Pancreatitis: An Evidence-Based Approach

Guru Trikudanathan, Daniel R.J. Wolbrink, Hjalmar C. van Santvoort, Shawn Mallery, Martin Freeman, Marc G. Besselink

Research output: Contribution to journalArticlepeer-review

214 Scopus citations


The incidence of acute pancreatitis continues to rise, inducing substantial medical and social burden, with annual costs exceeding $2 billion in the United States alone. Although most patients develop mild pancreatitis, 20% develop severe and/or necrotizing pancreatitis, requiring advanced medical and interventional care. Morbidity resulting from local and systemic complications as well as invasive interventions result in mortality rates historically as high as 30%. There has been substantial evolution of strategies for interventions in recent years, from open surgery to minimally invasive surgical and endoscopic step-up approaches. In contrast to the advances in invasive procedures for complications, early management still lacks curative options and consists of adequate fluid resuscitation, analgesics, and monitoring. Many challenges remain, including comprehensive management of the entire spectrum of the disease, which requires close involvement of multiple disciplines at specialized centers.

Original languageEnglish (US)
Pages (from-to)1994-2007.e3
Issue number7
StatePublished - May 2019

Bibliographical note

Publisher Copyright:
© 2019 AGA Institute


  • Acute Pancreatitis
  • Necrotizing Pancreatitis
  • Severe Acute Pancreatitis


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