As a final comment, I would like to add that, given the complexity of acute necrotizing pancreatitis, and considering that organ failure and infected necroses are the two factors that contribute most to increased mortality, patients with serious acute pancreatitis must be taken care of in a multi disciplinary way at a center that has an Intensive Care Unit ICU and the capacity for interventionist radiology and endoscopy. The latter should including ERCP Endoscopic Retrograde Cholangio-Pancreatography 14. 2. Petro MS, Shanbhag S, Chakraborty M, Phillips A, Windsor JA. Organ failure and infection of pancreatic necrosis as determinants of mortality in patients with acute pancreatitis. Gastroenterology 2010; 139: 813-820.
Como comentario final, dada la complejidad en la PAN y definidos la FO y la PAN infectada, como los dos factores que incrementan la mortalidad, se hace necesario que los pacientes con pancreatitis aguda grave sean atendidos en forma multidisciplinaria en un centro que cuente con Unidad de Cuidados Intensivos UCI, Radiología intervencionista, Endoscopias, incluyendo ERCP 14.