New method Clinical endoscopy| Volume 76, ISSUE 6, P1238-1241, December 2012

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Transgastrically placed endoscopic vacuum-assisted closure system as an addition to transgastric necrosectomy in necrotizing pancreatitis (with video)

Published:October 01, 2012DOI:


      Endoscopic transluminal débridement of infected pancreatic necrosis has been proved to be an important alternative to surgical débridement. Recently, endoscopic vacuum-assisted closure (EVAC) has been described as a new effective treatment option in upper intestinal anastomotic leaks.


      To test whether the EVAC can be applied to transgastrically accessible infected cavities.


      Single-center case study.


      Academic medical center.


      Two patients with necrotizing pancreatitis.

      Main Outcome Measurement

      Successful closure of leak.


      We successfully applied EVAC to treat transgastrically accessible necrotic cavities.


      Small case number.


      EVAC might be an important additional endoscopic treatment option for infected pancreatic necrosis, especially if established endoscopic treatment options fail.


      EVAC (endoscopic vacuum-assisted closure), VAC (vacuum-assisted closure)
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        • Banks P.A.
        • Freeman M.L.
        • Practice Parameters Committee of the American College of Gastroenterology
        Practice guidelines in acute pancreatitis 1.
        Am J Gastroenterol. 2006; 101: 2379-2400
        • Seifert H.
        • Wehrmann T.
        • Schmitt T.
        • et al.
        Retroperitoneal endoscopic debridement for infected peripancreatic necrosis.
        Lancet. 2000; 356: 653-655
        • Seifert H.
        • Biermer M.
        • Schmitt W.
        • et al.
        Transluminal endoscopic necrosectomy after acute pancreatitis: a multicentre study with long-term follow-up (the GEPARD Study).
        Gut. 2009; 58: 1260-1266
        • Gardner T.B.
        • Coelho-Prabhu N.C.
        • Gordon S.R.
        • et al.
        Direct endoscopic necrosectomy for the treatment of walled-off pancreatic necrosis: results from a multicenter U.S. series.
        Gastrointest Endosc. 2011; 73: 718-726
        • Vikatmaa P.
        • Juutilainen V.
        • Kuukasjarvi P.
        • et al.
        Negative pressure wound therapy: a systematic review on effectiveness and safety.
        Eur J Vasc Endovasc Surg. 2008; 36: 438-448
        • Thompson J.T.
        • Marks M.W.
        Negative pressure wound therapy.
        Clin Plast Surg. 2007; 34: 673-684
        • Holle G.
        • Riedel K.
        • von Gregory H.
        • et al.
        Vacuum-assisted closure therapy: current status and basic research.
        Unfallchirurg. 2007; 110: 490-504
        • Wedemeyer J.
        • Brangewitz M.
        • Kubicka S.
        • et al.
        Management of major postsurgical gastroesophageal intrathoracic leaks with an endoscopic vacuum-assisted closure system.
        Gastrointest Endosc. 2010; 71 (382-69)
        • Ahrens M.
        • Schulte T.
        • Egberts J.
        • et al.
        Drainage of esophageal leakage using endoscopic vacuum therapy: a prospective pilot study.
        Endoscopy. 2010; 42: 693-698
        • Loske G.
        • Schorsch T.
        • Muller C.
        Intraluminal and intracavitary vacuum therapy for esophageal leakage: a new endoscopic minimally invasive approach.
        Endoscopy. 2011; 43: 540-544
        • Weidenhagen R.
        • Gruetzner K.U.
        • Wiecken T.
        • et al.
        Endoscopic vacuum-assisted closure of anastomotic leakage following anterior resection of the rectum: a new method.
        Surg Endosc. 2008; 22: 1818-1825
        • Sermoneta D.
        • Di Mugno M.
        • Spada P.L.
        • et al.
        Intra-abdominal vacuum-asisted closure (VAC) after necrosectomy for acute necrotising pancreatitis: preliminary experience.
        Int Wound J. 2010; 7: 525-530