Transgastrically placed endoscopic vacuum-assisted closure system as an addition to transgastric necrosectomy in necrotizing pancreatitis (with video)

摘要

Background: Endoscopic transluminal débridement of infected pancreatic necrosis has been proved to be an important alternative to surgical débridement. Recently, endoscopic vacuum-assisted closure (EVAC) has been described as a new effective treatment option in upper intestinal anastomotic leaks. Objective: To test whether the EVAC can be applied to transgastrically accessible infected cavities. Design: Single-center case study. Setting: Academic medical center. Patients: Two patients with necrotizing pancreatitis. Main Outcome Measurement: Successful closure of leak. Results: We successfully applied EVAC to treat transgastrically accessible necrotic cavities. Limitations: Small case number. Conclusions: EVAC might be an important additional endoscopic treatment option for infected pancreatic necrosis, especially if established endoscopic treatment options fail.