Interventional strategies in infected necrotizing pancreatitis: Indications, timing, and outcomes

Figure 4 Overview of the step-up approaches of infected necrotizing pancreatitis patients. In the acute phase, multidisciplinary treatment for acute pancreatitis is recommended. Endoscopic necrosectomy or surgical step-up should be considered if there no clinical improvement is observed within 72 h. Open necrosectomy should be considered after video-assisted retroperitoneal debridement or minimal access retroperitoneal pancreatic necrosectomy. ETN: Endoscopic transluminal necrosectomy; STE: Sinus tract endoscopy; ETD: Endoscopic transluminal drainage; PCD: Percutaneous catheter drainage; VARD: Video-assisted retroperitoneal debridement; MARPN: Minimal access retroperitoneal pancreatic necrosectomy.