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Response to the Comment on "Outcome of Acute Pancreatic and Peripancreatic Collections Occurring in Patients With Acute Pancreatitis".

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necessity for intervention? Magnetic resonance imaging is capable of resolving the internal character of necrotic collections into mixtures of fluid and necrotic components, while CT, as used in this study,… Click to show full abstract

necessity for intervention? Magnetic resonance imaging is capable of resolving the internal character of necrotic collections into mixtures of fluid and necrotic components, while CT, as used in this study, lacks this capability. Is it possible that WON with a disproportionate amount of fluid over necrotic material might have a greater tendency to regress? Further, would continued untreated follow-up longer than the 3 months in the current study provide us more information regarding frequency of regression, and therefore reduce the indications for intervention? Data exist to lead us to believe that this might be so. As with any good study, the report from our Indian colleagues raises as many questions as it answers. Indeed, the management controversy regarding WON highlighted in this letter could be summarized as ‘‘Anything worth doing is worth overdoing!’’ versus ‘‘Don’t just do something, stand there!’’ Most likely, the truth lies somewhere in-between, and is yet to be determined.

Keywords: pancreatic peripancreatic; outcome acute; acute pancreatic; response comment; peripancreatic collections; comment outcome

Journal Title: Annals of surgery
Year Published: 2019

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