D0184 - Lap TEC for Walled Off Pancreatic Necrosis

David A. Iannitti, MD¹, Erin Baker, MD¹, Matt Strand, MD¹, Andrew Dries, MD¹, Stephen Deal, MD^2
1Atrium Health, Charlotte, NC; ²Carolina Digestive, Charlotte, NC

Introduction: Walled Off Pancreatic Necrosis (WOPN) is a result of acute pancreatitis. These cyst cavities have been traditionally drained via an open surgical approaches. More modern approaches with endoscopic drainage and debridment are used effectively for pancreatic pseudocysts and have been used for WOPN. These cases usually require several debridment procedures per patient. Evolution of surgical approaches with less invasive approaches continue to evolve.

Case Description/Methods: This video demonstrates a combined endoscopic and laparoscopic approach to debridment of a walled odd pancreatic necrosis through the posterior gastric wall. This approach we have termed "Lap TEC" stands for Laparoscopic Transgastric Endoscopically assisted Cystgastrostomy for a woman several months from an episode of acute pancreatitis resulting in a large symptomatic WOPN.

Discussion: Lap TEC is an effective approach for patients with walled off pancreatic necrosis. These patient should be managed by a multidisciplinary team including gastroenterologists and surgeons. Approach chosen for management of WOPN should include patient risk factors, size and location of WOPN, amount of cavitary debris an d local expertise. Lap TEC has demonstrated a high degree of safety and efficacy for patient requiring debridment and drainage of WOPN.


Disclosures:


David A. Iannitti, MD¹, Erin Baker, MD¹, Matt Strand, MD¹, Andrew Dries, MD¹, Stephen Deal, MD². D0184 - Lap TEC for Walled Off Pancreatic Necrosis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.