Endoscopy vs. Surgery as First-Line Treatment for Infected Pancreatic Necrosis

In the past, infected pancreatic necrosis was almost always treated by surgical means. Recent years have seen the development and dissemination of endoscopic techniques to access, drain, and debride pancreatic necrosis.

A recent multicenter, randomized trial was performed to compare the rate of adverse events or death during 6 months (primary endpoint) following endoscopic versus surgical therapy in patients with infected pancreatic necrosis. Endoscopic treatment comprised endoscopic drainage followed by endoscopic debridement (if needed), and surgery comprised percutaneous drainage followed by video-assisted retroperitoneal debridement (if needed).

Among 98 patients, the primary endpoint was similar between groups — a major adverse event or …