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 important factor to consider is that surgical necrosectomy in penguin and tension trials was vard or open necrosectomy, not minimally invasive infracolic/transgastric necrosectomy. complications profile differ between these surgical approaches significantly. 
ST3 General Surgery East Midlands | Interest in HPB & Advanced Endoscopy (ERCP/EUS) | @ALSGBIAcademy Social Media Lead & Robotics | Alumnus @BSMSMedschool