“Acute pancreatitis is the most common pancreatic disease worldwide. Necrotizing pancreatitis develops in approximately 20 to 30% of patients with acute pancreatitis. Pancreatic and peripancreatic necrosis that becomes infected nearly always leads
to invasive intervention. The current standard approach for infected necrotizing pancreatitis is a minimally invasive step-up approach with catheter drainage as the first step. International guidelines advise postponement of catheter drainage and administration of antibiotics until the infected pancreatic and peripancreatic necrosis has become encapsulated; such walled-off necrosis usually takes 4 weeks to develop.”

“This multicenter, randomized trial did not show the superiority of immediate catheter drainage over postponed catheter drainage in reducing complications in patients with infected necrotizing pancreatitis. Patients randomly assigned to the immediate-drainage group underwent more interventions for infected necrosis, whereas the postponed-drainage strategy averted the need for intervention in more than one third of the patients assigned to that group.
Our results do not support the hypothesis that catheter drainage performed immediately
after diagnosis of infected necrosis leads to better patient outcomes with fewer complications than postponed drainage.”

Boxhoorn, Lotte et al. “Immediate versus Postponed Intervention for Infected Necrotizing Pancreatitis.” The New England journal of medicine vol. 385,15 (2021): 1372-1381. Full Text for Emory Users