Treatment of pancreatic necrosis - the Multimodal Glasgow Algorithm

The 2013 APA/IAP consensus document (44) outlined the principles of early targeted organ support, nutritional (enteral) optimisation, avoidance of antibiotic prophylaxis / ERCP (in the absence of jaundice), and delayed minimally invasive intervention embedded within a “step-up” framework where possible. An in-depth discussion of the evidence supporting these principles is beyond the scope of this chapter and will be dealt with elsewhere. This chapter will focus on the indications and rationale for intervention, and the options available within a multi-modal management algorithm.