Minimally Invasive Approach to Managing Pancreatic Necrosis Has Value

Harrison JM, Li AY, Sceats LA, et al. Two-Port Minimally Invasive Nephron-Laparoscopic Retroperitoneal Debridement for Pancreatic Necrosis. J Am Coll Surg. 2024, in press.

Infected pancreatic necrosis often requires multiple debridement procedures; minimally invasive approaches such as video-assisted debridement and nephroscopy-assisted irrigation have been useful, but each approach has been associated with complications such as incisional hernia and the need for multiple procedures.

The authors provided a detailed description of their technique, which uses two drain ports and laparoscopic instruments to debride and drain pancreatic necrosis; this technique is useful for walled-off necrosis, and the article provides illustrations showing the approaches for left- and right-sided collections.

Experience with 11 patients is provided. Mean operative time was 159 minutes, and no repeat procedures were required. The authors concluded that this minimally invasive approach has potential value for management of pancreatic necrosis.