Published online Nov 27, 2022. doi: 10.4240/wjgs.v14.i11.1179
Peer-review started: September 11, 2022
First decision: September 26, 2022
Revised: October 8, 2022
Accepted: October 25, 2022
Article in press: October 25, 2022
Published online: November 27, 2022
Core Tip: Acute pancreatitis (AP) is a dynamic and evolving pathology with unpredictable natural course and no specific therapy. Most patients have mild and self-limiting AP where supportive therapy is sufficient. Still, an estimated 20% of patients may have severe AP that consumes healthcare resources and contributes to mortality risk. Risk stratification tools guide clinicians in resource allocation, patient counselling, and clinical audit. A multidisciplinary approach including evidence-based care is integral for good clinical outcomes. With regards to necrotizing pancreatitis, too much, too early and too little, too late should be avoided, and step-up philosophy of intervention should be adopted.