Surgical management of necrotizing pancreatitis.

In necrotizing pancreatitis, surgical treatment is indicated in patients with infected necrosis. Conservative management should be favored if necrosis remains sterile and the patient responds to intensive care therapy. Different surgical techniques have been established during the past years, including conventional drainage, open and semiopen drainage, and closed management with postoperative continuous lavage of the lesser sac. For experienced physicians, these techniques provide comparable results, and none has been proved to be superior to the others.