Endoscopic treatment of multilocular walled-off pancreatic necrosis with the multiple transluminal gateway technique

Mateusz Jagielski; Marian Smoczyński; Krystian Adrych

doi:10.5114/wiitm.2017.68298

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abstract:

Case report

Endoscopic treatment of multilocular walled-off pancreatic necrosis with the multiple transluminal gateway technique

Mateusz Jagielski

,

Marian Smoczyński

,

Krystian Adrych

Videosurgery Miniinv 2017; 12 (2): 199–205

DOI: https://doi.org/10.5114/wiitm.2017.68298

Online publish date: 2017/06/13

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The development of minimally invasive techniques allowed access to the necrotic cavity through transperitoneal, retroperitoneal, transmural and transpapillary routes. The choice of access to walled-off pancreatic necrosis (WOPN) should depend not only on the spread of necrosis, but also on the experience of the clinical center. Herein we describe treatment of a patient with multilocular symptomatic walled-off pancreatic necrosis using minimally invasive techniques. The single transmural access (single transluminal gateway technique – SGT) to the necrotic collection of the patient was ineffective. The second gastrocystostomy was performed using the same minimally invasive technique as an extra way of access to the necrosis (multiple transluminal gateway technique – MTGT). In the described case the performance of the new technique consisting in endoscopic multiplexing transmural access (MTGT) was effective enough and led to complete recovery of the patient.

keywords:

Endoscopic treatment of multilocular walled-off pancreatic necrosis with the multiple transluminal gateway technique

Mateusz Jagielski , Marian Smoczyński , Krystian Adrych

walled-off pancreatic necrosis, acute pancreatitis, endoscopic drainage, transmural drainage

Mateusz Jagielski

,

Marian Smoczyński

,

Krystian Adrych