Laparoscopic transgastric necrosectomy for infected pancreatic necrosis

David J Worhunsky, MD, Monica M Dua, MD, Jeffrey A Norton, MD, Brendan C Visser, MD. Stanford University Medical Center.

Open pancreatic necrosectomy remains associated with significant morbidity. In this video, we present a case of a laparoscopic transgastric necrosectomy, a novel minimally invasive technique for debridement of pancreatic necrosis. Two laparoscopic ports are placed directly into the insufflated stomach. The posterior gastric wall is opened to create a cystgastrostomy through which the necrosum is debrided. The cystgastrostomy is left open for continued internal drainage into the stomach, thereby limiting the repeated interventions often associated with other minimally invasive techniques for pancreatic debridement.

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