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Endoscopic necrosectomy in necrotising pancreatitis: indication is the key
  1. Hjalmar C van Santvoort1,
  2. Marc G Besselink1,
  3. Olaf J Bakker1,
  4. Frank P Vleggaar2,
  5. Robin Timmer3,
  6. Bas L Weusten3,
  7. Hein G Gooszen1
  8. on behalf of the Dutch Pancreatitis Study Group
  1. 1Department of Surgery, University Medical Center Utrecht, The Netherlands
  2. 2Department of Gastroenterology and Hepatology, University Medical Center, Utrecht, The Netherlands
  3. 3Department of Gastroenterology, St. Antonius Hospital Nieuwegein, The Netherlands
  1. Correspondence to Prof Hein G Gooszen, Chairman Dutch Pancreatitis Study Group, Radboud University Nijmegen Medical Center, PO Box 9101, 6500 MB Nijmegen, The Netherlands; h.gooszen{at}ok.umcn.nl/h.vansantvoort{at}umcutrecht.nl

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We read with great interest the paper by Seifert et al on the outcome of endoscopic necrosectomy in 93 patients with necrotising pancreatitis.1 We congratulate the authors in completing a multicentre study in such a complicated group of patients. The authors conclude that endoscopic necrosectomy has good initial success and favourable long-term outcome. Complication rate and mortality rate were 25% and 7.5%, respectively. Although it was suggested that these results may compare favourably with recent series on surgical necrosectomy, we feel these data should be interpreted with caution.

The primary indication for necrosectomy in patients with necrotising pancreatitis is infected necrosis, as is stated in international guidelines.2–4 Intervention in …

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