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

Table 1 Overview of possible interventions in infected necrotizing pancreatitis

		Indications	Contraindications	Most common complications	Ref.
Interventions	Endoscopic transluminal drainage	Standard first step for INP, standard for PFC treatment	Unencapsulated collections, distance from gastroduodenal duct (> 1 cm), vascular pseudoaneuryms	Major bleedings, perforation, post-procedure infection, recurrence, migration of the stent	[37,38,40]
	Endoscopic necrosectomy	No improvement in clinical condition within < 72 h after ETD, follow-up treatment	Large necrotic areas, dense necrosis, disconnected duct	Bleeding, perforation, pancreatic fistula, infections	[37,48,50]
	Percutaneous catheter drainage	Hardly accessible ANC, ETD not feasible, as combination with ETD	Intracystic haemorrhagia, pancreatic ascites	Intestinal fistula, infection	[36,51]
	Open surgery	Infected necrosis, suspected perforation, abdominal compartment syndrome, ischemia, intrabadominal haemorrhagia, poorly walled off necrosis, final treatment option if other interventions fail	No clear contraindications reported	Bleeding, infection, perforation, multi-organ failure	[52,53]
	Minimally invasive surgery	Infected necrosis	Extensive or hardly accessible collections	Bleeding, infection, perforation	[44,57,58]

INP: Infected necrotizing pancreatitis; ANC: Acute necrotic collection; ETD: Endoscopic transluminal drainage.