Transgastric Pancreatic Debridement: a Step-by-step Guide to a Single-staged Procedure for Walled-off Pancreatic Necrosis.

Treatment of necrotizing pancreatitis (NP) requiring intervention must be tailored to each patient's individual clinical situation. Surgical transgastric debridement addresses necrosis confined to the lesser sac with the option to perform cholecystectomy in a single intervention.1 With proper patient selection, this technique achieves resolution of necrosis in 90% of patients.2 In the setting of disconnected pancreatic duct syndrome, cystogastrostomy achieves pancreatic tail drainage with durable long-term success in 80% of patients.3 This case presentation and step-by-step walkthrough demonstrates critical technical aspects and decision-making for surgical transgastric debridement of walled-off pancreatic necrosis.