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

BackgroundEndoscopic 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.ObjectiveTo test whether the EVAC can be applied to transgastrically accessible infected cavities.DesignSingle-center case study.SettingAcademic medical center.PatientsTwo patients with necrotizing pancreatitis.Main Outcome MeasurementSuccessful closure of leak.ResultsWe successfully applied EVAC to treat transgastrically accessible necrotic cavities.LimitationsSmall case number.ConclusionsEVAC might be an important additional endoscopic treatment option for infected pancreatic necrosis, especially if established endoscopic treatment options fail.