Background and objective The Atlanta classification of acute pancreatitis enabled standardised reporting of research and aided communication between clinicians.

A minimally invasive step-up approach, as compared with open necrosectomy, reduced the rate of the composite end point of major complications or death among patients with necrotizing pancreatitis and infected necrotic tissue. (Current Controlled Trials number, ISRCTN13975868.)

The 2016 HaPanEU/United European Gastroenterology guidelines provide evidence-based recommendations concerning key aspects of the medical and surgical management of chronic pancreatitis based on current available evidence. These recommendations should serve as a reference standard for existing management of the disease and as a guide for future clinical research.

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The Dutch Digestive Disease Foundation, Fonds NutsOhra, and the Netherlands Organization for Health Research and Development.

mon and potentially lethal disorder. 1 In the United States alone, more than 50 000 patients are admitted with acute pancreatitis each year. 2 One of the most dreaded complications in these patients is infected necrotizing pancreatitis that leads to sepsis and is often followed by multiple organ failure. 3 In these patients interventions are necessary to debride the infected necrosis, but the interventions themselves cause substantial morbidity. 4-6 The treatment of infected necrotizing pancreatitis has undergone fundamental changes in recent years. Whenever possible, intervention is postponed until the collections with necrosis are demarcated. 7,8 Demarcation facilitates necrosectomy and reduces complications related to the drainage and debride-ment procedures. 9 A recent randomized trial demonstrated that a step-up approach of percutaneous catheter For editorial comment see p 1084.

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