Is necrosectomy obsolete for infected necrotizing pancreatitis? Is a paradigm shift needed?

Table 1 Results of nonsurgical or conservative treatment for necrotizing pancreatitis published mainly after 2000

Ref.	Year	Cases(n)	Type(Intend)	Morbidity(%)	Reoperationrate (%)	Mortality(%)	Remark
Sterile
Bradley[1]	1991	40	Nonsurgical			10.0
Uomo et al[61]	1996	146	Nonsurgical			9.5	1984-1993
Baril et al[20]	2000	26	Antibiotics		0	7.0	1993-1997
Büchler et al[62]	2000	56	Conservative			1.8	Two false negatives excluded
Zerem et al[41]	2009	20	Conservative		15.0	0.0	Randomized controlled study
Garg et al[54]	2010	137	Conservative			15.3	1997-2008
van Santvoort et al[18]	2011	386	Conservative			7.3	21 Dutch hospitals
Babu et al[46]	2013	14	Conservative			7.0	Step-up; one INP
Infected
Dubner et al[8]	1996	3	Antibiotics	0	0	0.0	Unstable or refused surgery
Baril et al[20]	2000	6	Antibiotics		0	33.0	1993-1997
Runzi et al[63]	2005	16	Antibiotics	62		12.5
Lee et al[19]	20071	8	Antibiotics	0	0	0.0
Garg et al[54]	20101	71	Conservative or PCD			25.4	1997-2008
van Santvoort et al[18]	2011	11	Antibiotics	0	0	0.0	21 Dutch hospitals
Sterile + infected
Büchler et al[62]	2000	58	Conservative			5.0	Two false negatives
Garg et al[54]	20101	208	Medical			18.8	1997-2008

¹Non-randomized controlled study. INP: Infected necrotizing pancreatitis; PCD: Percutaneous drainage.