Research progress of surgical treatment status and optimal timing of therapy in acute necrotizing pancreatitis

Acute necrotizing pancreatitis (ANP) is a common and severe acute disease. The necrosis of pancreatic tissue caused by ANP can lead to serious complications and high mortality. Early surgical treatment can help prevent further disease progression and significantly improve the survival rate of patients. With continuous advancements in medical technology, minimally invasive approaches have gradually occupied the mainstay of surgical treatment for ANP, and its characteristics of small trauma and rapid recovery have received extensive attention. Studies have pointed out that conservative management remains the first-line approach for patients with mild ANP. However, for patients with severe complications such as infectious necrosis, abdominal compartment syndrome, bleeding or unstable vital signs, timely surgical intervention is critical for improving outcomes. Based on a comprehensive review of the current situation of surgical treatment of ANP, this review focuses on the types and indications of both conservative and surgical treatments, and provides an in-depth discussion of various interventional therapy in ANP, including ultrasound-guided percutaneous catheter drainage (PCD), radiation interventional therapy, and endoscopic interventional therapy. This review emphasizes the importance of interventional treatment timing in the prognosis of ANP patients, elaborates on the advantages of early interventional therapy and appropriate timing strategies, and explores future trends and research directions to provide clinicians in evidence-based treatment plans and optimizing interventional treatments.