Endoscopic treatment of extensive walled-off pancreatic necrosis with the use of single transluminal gateway transcystic multiple drainage (SGTMD)

The paper presents a description of the course of severe acute necrotizing pancreatitis as well as endoscopic treatment of an extensive infected walled-off pancreatic necrosis (WOPN), being the consequence of acute pancreatitis. The basic strategy of interventional treatment was to extend access to necrotic areas with use of single transluminal gateway transcystic multiple drainage (SGTMD). Endoscopic transmural access (transgastric) was applied. Endoscopic necrosectomy under fluoroscopic guidance was repeated nine times during active transluminal drainage. Endotherapy with use of SGTMD, as well as endoscopic necrosectomy became a successful and safe technique of treatment. Moreover, the paper proved the efficiency of endotherapy in the treatment of complete pancreatic duct disruption in the course of acute necrotizing pancreatitis.