This review outlines advances in our understanding of the pathogenesis of severe acute pancreatitis. It reviews the current general management of these patient and the various advances in the endoscopic treatment approaches for patients with infected pancreatic necrosis and those who do not improve on conservative management. The technique of laparoscopic infracolic pancreatic necrosectomy and irrigation of the lesser sac is described in detail. Copyright 2002, Elsevier Science (USA). All rights reserved.
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