Delayed Drainage of Infected Pancreatic Necrosis Is Safe

The current American Gastroenterological Association guidelines recommend strong consideration of catheter drainage of infected necrotic pancreatitis (Gastroenterology 2020; 158:67). Traditional teaching has been that intervention should be delayed until collections of necroses are fully walled off. With advances in minimally invasive percutaneous and endoscopic interventions, discussion has arisen about potential benefits of earlier drainage.

Dutch investigators randomized 104 patients with infected necrotizing pancreatitis (within 35 days of presentation) to either early or delayed catheter drainage. All patients received antibiotics. Early intervention was performed within 24 hours of randomization; drainage was postponed in the delayed g…