Acute Necrotizing Pancreatitis—Advances and Challenges in Management for Optimal Clinical Outcomes
Acute necrotizing pancreatitis (ANP), characterized by necrosis of pancreatic and/or peripancreatic tissues, is a potentially severe and life-threatening complication of acute pancreatitis, exhibiting a considerable mortality rate, particularly in the presence of infection, with rates ascending to 2...
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MDPI AG
2025-06-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/61/7/1186 |
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| author | Ioana Dumitrascu Narcis Octavian Zarnescu Eugenia Claudia Zarnescu Mihai Radu Pahomeanu Alexandru Constantinescu Dana Galieta Minca Radu Virgil Costea |
| author_facet | Ioana Dumitrascu Narcis Octavian Zarnescu Eugenia Claudia Zarnescu Mihai Radu Pahomeanu Alexandru Constantinescu Dana Galieta Minca Radu Virgil Costea |
| author_sort | Ioana Dumitrascu |
| collection | DOAJ |
| description | Acute necrotizing pancreatitis (ANP), characterized by necrosis of pancreatic and/or peripancreatic tissues, is a potentially severe and life-threatening complication of acute pancreatitis, exhibiting a considerable mortality rate, particularly in the presence of infection, with rates ascending to 20–30%. Contrast-enhanced computed tomography is the definitive diagnostic standard, although treatment is determined by illness severity and the presence of secondary infection. The management of this condition has undergone considerable evolution, transitioning from initial surgical intervention to a more progressive, minimally invasive strategy. Initial management emphasizes aggressive fluid resuscitation, nutritional support, and monitoring of organ dysfunction. Infected necrosis is a critical factor influencing prognosis and requires intervention, typically starting with percutaneous drainage or endoscopic necrosectomy prior to evaluating surgical debridement. Recent advancements, such as the implementation of endoscopic and minimally invasive techniques, have enhanced outcomes by decreasing morbidity and mortality linked to open surgery. Despite these advancements, optimal treatment strategies are patient-specific and necessitate a multidisciplinary approach. Additional research is necessary to enhance guidelines and optimize patient outcomes. |
| format | Article |
| id | doaj-art-38549c20281c47b38ed6abc3b86cef06 |
| institution | Kabale University |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-38549c20281c47b38ed6abc3b86cef062025-08-20T03:58:30ZengMDPI AGMedicina1010-660X1648-91442025-06-01617118610.3390/medicina61071186Acute Necrotizing Pancreatitis—Advances and Challenges in Management for Optimal Clinical OutcomesIoana Dumitrascu0Narcis Octavian Zarnescu1Eugenia Claudia Zarnescu2Mihai Radu Pahomeanu3Alexandru Constantinescu4Dana Galieta Minca5Radu Virgil Costea6Department of General Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of General Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of General Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Internal Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Internal Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Public Health, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of General Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaAcute necrotizing pancreatitis (ANP), characterized by necrosis of pancreatic and/or peripancreatic tissues, is a potentially severe and life-threatening complication of acute pancreatitis, exhibiting a considerable mortality rate, particularly in the presence of infection, with rates ascending to 20–30%. Contrast-enhanced computed tomography is the definitive diagnostic standard, although treatment is determined by illness severity and the presence of secondary infection. The management of this condition has undergone considerable evolution, transitioning from initial surgical intervention to a more progressive, minimally invasive strategy. Initial management emphasizes aggressive fluid resuscitation, nutritional support, and monitoring of organ dysfunction. Infected necrosis is a critical factor influencing prognosis and requires intervention, typically starting with percutaneous drainage or endoscopic necrosectomy prior to evaluating surgical debridement. Recent advancements, such as the implementation of endoscopic and minimally invasive techniques, have enhanced outcomes by decreasing morbidity and mortality linked to open surgery. Despite these advancements, optimal treatment strategies are patient-specific and necessitate a multidisciplinary approach. Additional research is necessary to enhance guidelines and optimize patient outcomes.https://www.mdpi.com/1648-9144/61/7/1186acute pancreatitispancreatic necrosismanagementdrainageendoscopic necrosectomystep-up approach |
| spellingShingle | Ioana Dumitrascu Narcis Octavian Zarnescu Eugenia Claudia Zarnescu Mihai Radu Pahomeanu Alexandru Constantinescu Dana Galieta Minca Radu Virgil Costea Acute Necrotizing Pancreatitis—Advances and Challenges in Management for Optimal Clinical Outcomes Medicina acute pancreatitis pancreatic necrosis management drainage endoscopic necrosectomy step-up approach |
| title | Acute Necrotizing Pancreatitis—Advances and Challenges in Management for Optimal Clinical Outcomes |
| title_full | Acute Necrotizing Pancreatitis—Advances and Challenges in Management for Optimal Clinical Outcomes |
| title_fullStr | Acute Necrotizing Pancreatitis—Advances and Challenges in Management for Optimal Clinical Outcomes |
| title_full_unstemmed | Acute Necrotizing Pancreatitis—Advances and Challenges in Management for Optimal Clinical Outcomes |
| title_short | Acute Necrotizing Pancreatitis—Advances and Challenges in Management for Optimal Clinical Outcomes |
| title_sort | acute necrotizing pancreatitis advances and challenges in management for optimal clinical outcomes |
| topic | acute pancreatitis pancreatic necrosis management drainage endoscopic necrosectomy step-up approach |
| url | https://www.mdpi.com/1648-9144/61/7/1186 |
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