Abstract
Acute pancreatitis (AP) is the third leading cause of gastroenterology‐related hospitalizations in the United States, accounting for approximately 280 000 admissions annually and more than US$2 billion in annual healthcare costs. There are four types of local collections associated with AP, including acute fluid collection, pancreatic pseudocyst (PP), acute necrotic collection, and walled‐off necrosis. Endoscopic transmural drainage of PP was first described in 1985 and has subsequently evolved. Endoscopic drainage has become the preferred standard of care for symptomatic PP. Historically, surgical debridement was the traditional management strategy for symptomatic necrosis with and without the presence of infection. As new approaches continue to evolve, there is increasingly more evidence to substantiate the use of endoscopic necrosectomy, laparoscopic transperitoneal or video‐assisted retroperitoneal debridement, and percutaneous drainage.