Publication Name	World Journal of Gastrointestinal Surgery
Manuscript ID	126411
DOI	10.4240/wjgs.126411
Country	Italy

Category	Surgery
Manuscript Type	Minireviews
Article Title	Management of acute necrotizing pancreatitis: Current evidence, controversies and future perspectives
Manuscript Source	Invited Manuscript
All Author List	Matteo Matteucci, Riccardo Masserano, Daniele Tesoro, Andrea Colombo, Luca Portigliotti, Giampaolo Formisano and Paolo Pietro Bianchi
Funding Agency and Grant Number
Corresponding Author	Matteo Matteucci, DM, MD, General Surgery Residence Program, University of Milan, Via Festa Del Perdono 7, Milan 20122, Lombardy, Italy. matteo.matteucci@unimi.it
Key Words	Necrotizing pancreatitis; Infected pancreatic necrosis; Step-up approach; Minimally invasive necrosectomy; Endoscopic necrosectomy; Antibiotic prophylaxis; Pancreatic necrosis; Acute pancreatitis
Core Tip	The management of acute necrotizing pancreatitis has shifted from early, aggressive intervention to a delayed, staged, individualized approach. This review synthesizes current evidence concerning moderate fluid resuscitation, early enteral feeding, and the strict reservation of antibiotics for confirmed or strongly suspected infection rather than isolated biomarker thresholds. A step-up approach, endoscopic or surgical, with drainage postponed whenever clinically feasible, remains the standard of care. We further propose an original risk-adapted diagnostic-therapeutic algorithm that separates risk stratification from treatment escalation, offering a practical framework to guide clinicians through the field’s remaining areas of controversy.
Citation	Matteucci M, Masserano R, Tesoro D, Colombo A, Portigliotti L, Formisano G, Bianchi PP. Management of acute necrotizing pancreatitis: Current evidence, controversies and future perspectives. World J Gastrointest Surg 2026; In press DOI: https://doi.org/10.4240/wjgs.126411
PDF	126411-in-press.pdf

Received	2026-08-04 08:16
Peer-Review Started	2026-08-04 08:17
First Decision by Editorial Office Director
Return for Revision	2026-08-11 09:17
Revised	2026-08-23 08:06
Publication Fee Transferred
Second Decision by Editor	2026-10-26 07:15
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-10-26 09:56
Articles in Press	2026-10-26 09:56
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-9366 (online)
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Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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