Minimally Invasive Approach to Treatment of Acute Pancreatitis

The surgical management of complicated acute pancreatitis (AP) has significantly evolved over the last 20 years. The introduction of several novel minimally invasive techniques has given the modern general surgeon an increasing number of options to counter a highly morbid disease. Early and aggressive surgical intervention with open necrosectomy had been the standard of care for many years, which unfortunately resulted in extremely high rates of morbidity and mortality. This chapter will bring the general surgeon up to date on several key concepts targeted specifically to improve outcomes for patients with AP. We will start with background epidemiological information about AP and further discuss severity scoring, disease-specific definitions, as well as recommendations for radiographic investigation. We will review the initial goals of supportive care for patients with AP, their nutrition optimization, and examine several minimally invasive surgical techniques.