Abstract
The use of EUS (endoscopic ultrasound) guided drainage with endoscopic LAMS (lumen apposing metal stent) necrosectomy is an emerging treatment option for walled-off pancreatic necrosis (WOPN) secondary to acute severe pancreatitis. It can delay or remove the need for open necrosectomy, which is associated with high mortality. However, the former is not always successful and salvage transgastric necrosectomy can achieve internal drainage using the tract created during endoscopy. In this article we will describe our unit’s experience with WOPN in two patients and suggest a step-up approach to treating WOPN which includes salvage transgastric necrosectomy when endoscopic necrosectomy and washouts failed.
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