Pancreatic Debridement via Sinus Tract Endoscopy

Abstract

Sinus tract endoscopy (STE) is a minimally invasive technique for debridement of dead or infected tissue. STE is usually used for treatment of infected pancreatic or peripancreatic necrosis, though other applications have been described. STE involves placement of a percutaneous drain followed by fluoroscopically guided dilation of the drain tract to allow placement of a working sheath. An endoscope is then introduced through the sheath and used to debride necrotic tissue. A drain is then replaced through the same tract at the conclusion of the procedure. In this case we use STE to debride infected peripancreatic necrosis caused by a traumatic pancreatic injury and complicated by an enteric fistula.