Endoscopic Transgastric Necrosectomy for Infected Necrotizing Pancreatitis

Hines and Donald discuss Bakker et al's study comparing minimally invasive techniques against surgery in 22 patients with infected necrotizing pancreatitis. This trial demonstrates that, compared with surgical debridement, a less invasive approach of natural orifice transluminal endoscopic surgery, using transoral endoscopic drainage of infected and necrotic pancreatic collections, significantly reduced the overall inflammatory state and also resulted in lower rates of new-onset multiorgan failure. They imply that endoscopic drainage, even if performed relatively earlier, will lead to fewer complications and less morbidity than open or even video-assisted necrosectomy.