Table 5.

Situations in which open necrosectomy is a valid option for treatment of infected pancreatic necrosis

Treatment failure or complication (e.g., persistent bleeding after attempted endovascular treatment) after step-up management procedure

Bowel ischemia or perforation (suspected/verified) due to necrosis

Ongoing open abdomen with simultaneous indication for necrosectomy

Disconnected left pancreatic remnant fueling the disease

Insufficient experience or equipment for mini-invasive necrosectomy

Biliary pancreatitis with simultaneous need for cholecystectomy

Anatomically widespread necrosis