Infection complicating pancreatic necrosis leads topersisting sepsis,multiple organ dysfunction syndromeand accounts for about half the deaths that occur followingacute pancreatitis.Severe cases due to gallstones requireurgent endoscopic sphincterotomy.Patients withpancreatic necrosis should be followed with serialcontrast enhanced computed tomography(CE-CT)and ifinfection is suspected fine needle aspiration of thenecrotic area for bacteriology(FNAB)should beundertaken.Treatment of sterile necrosis should initiallybe non-operative.In the presence of infectionnecrosectomy is indicated.Although traditionally this hasbeen by open surgery,minimally invasive procedures area promising new altemative.There are many unresolvedissues in the management of pancreatic necrosis.Theseinclude,the use of antibiotic prophylaxis,the preciseindications for and frequency of repeat CE-CT and FNAB,and the role of enteral feeding. Infection complicating pancreatic necrosis leads topersisting sepsis, multiple organ dysfunction syndrome and accounts for about half the deaths that occur followingacute pancreatitis. Severe cases due to gallstones requireurgent endoscopic sphincterotomy. Patients with pancreatic necrosis leads topersisting sepsis, multiple organ dysfunction syndromeand accounts for is suspected fine needle aspiration of thenecrotic area for bacteriology (FNAB) should beundertaken.Treatment of sterile necrosis should initially be nonoperative.In the presence of infectionnecrosectomy is indicated .Although traditionally this hasbeen by open surgery, minimally invasive procedures area promising new altemative. There are many unresolvedissues in the management of pancreatic necrosis. Theseinclude, the use of antibiotic prophylaxis, the preciseindications for and frequency of repeat CE-CT and FNAB, and the role of enteral feeding.