Gut and Liver  2010;4(1):140-145

EUS-Guided Multitransgastric Endoscopic Necrosectomy for Infected Pancreatic Necrosis with Noncontagious Retroperitoneal and Peritoneal Extension.

Ja Eun KOO 1 ; Do Hyun PARK ; Joo OH ; Young Hee LEE ; Sung Hoon MOON ; Sang Soo LEE ; Dong Wan SEO ; Sung Koo LEE ; Myung Hwan KIM

Affiliations

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Keywords

Infected pancreatic necrosis; Pancreatitis; Endoscopic necrosectomy; Endoscopic ultrasound; Transmural drainage

Country

Republic of Korea

Language

English

Abstract

Endoscopic necrosectomy was introduced as a safe and effective treatment modality for infected pancreatic necrosis. Although there have been many reports of endoscopic drainage of retroperitoneal pancreatic necrosis, the optimal endoscopic management of pancreatic necrosis extending to the noncontagious retroperitoneal and peritoneal spaces has yet to be established. We report herein a patient with infected pancreatic necrosis with noncontagious retroperitoneal and peritoneal extension who was treated successfully by endoscopic ultrasound (EUS)-guided multiple cystogastrostomy and endoscopic necrosectomy. EUS-guided multitransgastric necrosectomy may be technically feasible and effective for the management of infected pancreatic necrosis with noncontagious retroperitoneal and peritoneal extension that demonstrates suitable anatomy. Further studies to assess the efficacy and safety of this technique are needed before its routine clinical use can be recommended.