Introduction
avascular necrosis, necrosum, gastrointestinal-related, necrosis
ACUTE PANCREATITIS, AVASCULAR NECROSIS, CAVITY, NECROSIS, NECROTIC DEBRIS
Acute pancreatitis is one of the leading causes of gastrointestinal-related admission to hospital [The invasive approaches for managing WON have evolved over the past decade [Nevertheless, in the case of iWON with deep extension (iWONde, i.e., the necrosis is diffusely distributed throughout the abdomen), it is something that still represents a challenging scenario for those minimal-access approaches [In this study, we attempted to solve the dilemma that no stand-alone minimal-access approach existed is suited for management of the infected necrosum with deep extension after failure of the “step-up” approach. Here, we introduced a minimal-access video-assisted retroperitoneal and/or transperitoneal debridement (hereafter called VARTD) that applies multi-mini-incision access for providing a practicable avenue to achieve sufficient clearance of the large avascular necrosis as much as possible, along with a continuous postoperative lavage by way of the flow that flushes from upper cavity towards lower zone, which may allow easy to irrigation and drainage of residual necrotic debris. The aim of this prospective single-arm study was to assess the effectiveness and safety of the VARTD for the iWONde.