The Role of Open Necrosectomy in the Current Management of Acute Necrotizing Pancreatitis: A Review Article

Table 1

Indications for open necrosectomy [14, 17].

The operation should be undertaken as late as possible, when necroses have been ceased, viable and nonviable tissues are well demarcated, and infected necrotic tissues are “walled off”.
Pancreatic and/or peripancreatic necrosis complicated by documented infection (guided FNA culture or extraluminal retroperitoneal gas)
Sterile necrosis
(a) Progressive clinical deterioration despite maximal medical  treatment
(b) “Fulminant acute pancreatitis”
Massive hemorrhage or hollow viscus perforation