Indications for surgical intervention in necrotizing pancreatitis, and the specific technique to be employed, have been controversial. Accumulating data suggest that pancreatic debridement is not beneficial in patients with sterile pancreatic necrosis. Infected pancreatic necrosis, on the other hand, is widely accepted as an absolute indication for surgical intervention. The choice of a specific technique (conventional closed drainage, lesser sac lavage, or open packing) depends upon the extent and the location of the infected process. Open packing is superior for patients with extensive infected necrosis.