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Severe Acute Pancreatitis: Have We Defined the Role of Palliative Care?

Sunil Shenvi*

In the last many years, necrosectomy that was done with wrong indications or at the wrong time has harmed more patients than it could benefit. It is the persistence and perseverance of bold pancreatic surgeons who continued the brave struggle in spite of poor results, which has made it possible today that we can treat the majority of Severe Acute Pancreatitis (SAP) patients with acceptable morbidity and mortality. As this evolution of surgery for SAP continues and pancreatic surgeons debate to reach consensus, subgroups of patients who have highest mortality are emerging. This is the time to start selecting patients who really benefit from the aggressive surgical treatment and sparing a small subgroup of the patients who will have worse results irrespective of the best possible treatment from unnecessary intervention. Considering palliative care in these patients to avoid futile interventions looks like a reasonable approach and needs further study.