OBJECTIVE: To analyze the impact of a conservative strategy of management in @entity1 with @entity788 , reserving intervention for @entity1 with documented @entity281 or the late complications of organized @entity39 . SUMMARY BACKGROUND DATA: The role of surgery in @entity1 with sterile @entity39 remains controversial. Although a conservative approach is being increasingly used, few studies have evaluated this strategy when applied to the entire spectrum of @entity1 with @entity788 . METHODS: The authors reviewed 1,110 consecutive @entity1 with acute @entity788 managed at Brigham and @entity1 's Hospital between January 1, 1995, and January 1, 2000, focusing on those with @entity39 documented by contrast-enhanced computed tomography. Fine-needle aspiration, the presence of extraintestinal gas on computed tomography, or both were used to identify @entity281 . RESULTS: There were 99 (9%) @entity1 with @entity788 treated, with an overall death rate of 14%. In three @entity1 with underlying medical problems, the decision was made initially not to intervene. Of the other 62 @entity1 without documented @entity281 , all but 3 were managed conservatively; this group's death rate was 11%. Of these seven deaths, all were related to @entity177 . Five @entity1 in this group eventually required surgery for organized @entity39 , with no deaths. Of the 34 @entity1 with infected @entity39 , 31 underwent surgery and 3 underwent percutaneous drainage. Only four (12%) of these @entity1 died, all of @entity177 . Of the total 11 @entity1 who died, few if any would have been candidates for earlier surgical intervention. CONCLUSIONS: These results suggest that conservative strategies can be applied successfully to manage most @entity1 with @entity788 , although some will eventually require surgery for symptomatic organized @entity39 . Few if any @entity1 seem likely to benefit from a more aggressive strategy.

XXXX : contemporary analysis of 99 consecutive cases.

@entity1 :: ('9606', 'Species') :: ['patients', 'Women'] @entity788 :: ('MESH:D010190', 'Disease') :: ['pancreatitis', 'necrotizing pancreatitis'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis', 'pancreatic necrosis'] @entity177 :: ('MESH:D051437', 'Disease') :: ['multiorgan failure'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection']
@entity788 :: (MESH:D010190,Disease) :: ['Necrotizing pancreatitis']
