Management of severe pancreatic necrosis.

Pancreatic necrosis is a form of severe pancreatitis associated with high morbidity and mortality. In this condition there is necrosis of pancreatic tissue with pancreatic duct disruption leading to release and activation of pancreatic enzymes. This in turn causes peripancreatic necrosis and formation of fluid collections. The diagnosis of pancreatic necrosis is made by contrast-enhanced CT scan of the abdomen. The management of pancreatic necrosis is controversial. No randomized clinical trials are available for guidance in treatment of pancreatic necrosis. Experience, collaboration, and knowledge of the managing teams play a major role in successful treatment. Early percutaneous drainage with frequent monitoring of the catheters is the hallmark of our approach. Using this approach, it is possible to significantly decrease the rate of morbidity and mortality associated with this disease and its treatment.