- All patients with necrotizing pancreatitis with the following features should be referred to a regional HPB centre for discussion:
- Greater than 30% necrosis of the pancreas or ANCs on early CT (within seven days of admission)
- Persisting organ dysfunction for greater than 48 h requiring organ support (e.g. ventilation, renal replacement therapy)
- Infected WON requiring drainage or necrosectomy, gastric or duodenal outflow obstruction secondary to acute peripancreatic collections, pseudocyst or WON
- Evidence of haemorrhage on CT