Surgery for necrotizing acute pancreatitis: surgical approach, morbidity and challenges encountered: experience from a tertiary care hepatopancreatobiliary unit in Sri Lanka

In resource-limited environments, the step-up approach to IPN is frequently constrained by service availability rather than intent. Open necrosectomy remains an essential salvage strategy when minimally invasive interventions are unavailable or unsuccessful, but is associated with significant morbidity. Careful patient selection, delayed intervention, and multidisciplinary management are critical to achieving acceptable outcomes.