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Modern Surgical Concepts in the Treatment of Severe Acute Pancreatitis– An Individualized Approach to the Patient

Angst E Storni F and Gloor B

Treatment of patients suffering from severe acute pancreatitis still represents a challenge. Over the last decades there was a clear shift from early repeated open surgical procedures to delayed minimal invasive surgical and/or endoscopic interventions. The initial systemic inflammatory response syndrome is best treated conservatively in the intensive care unit. Surgical or interventional procedures are indicated based on the clinical course. Drains placed under radiological guidance are usually the first step. If further treatment is necessary a minimal invasive approach is preferred. Delaying surgery until the third week after disease onset renders necrosectomy less tedious.