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

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.