Endoscopic Treatment Superior to Surgical for Infected Pancreatic Necrosis

Infected pancreatic necrosis is one of the most serious complications of severe necrotizing pancreatitis. In the past, identification of infected necrosis led to immediate open debridement, with high mortality and morbidity. Now, these patients are often managed with targeted antibiotics, watchful waiting, and less-invasive procedures, including minimally invasive laparoscopic or retroperitoneal surgical debridement, percutaneous drainage and debridement, and endoscopic transgastric necrosectomy. However, whether one minimally invasive technique is better than another is unknown.

To compare outcomes of endoscopic versus surgical treatments, 22 patients with infected pancreatic necrosis were randomized to receive endoscopic transgastric necro…