Surgery in acute pancreatitis. The United States experience.

Considerable controversy has existed in the United States regarding the operative management of acute pancreatitis. Recently, areas of consensus have begun to form regarding necrotizing pancreatitis and biliary pancreatitis. However, the role of surgery and endoscopy for the prevention of recurrent acute pancreatitis in patients with pancreas divisum has not as yet been established. In the United States, few areas of contemporary surgery have remained as controversial as the operative approach to patients with acute pancreatitis. Recently, however, newer methodologies have appeared that seem capable of addressing those current surgical disputes that exist in necrotizing pancreatitis, biliary pancreatitis, pancreas divisum, and in the various complications of acute pancreatitis.