Süveran Mustafa, Boynukara Can, Piyade Betul, Cecen Recep, Sisman Gürhan
Gastroenterology and Hepatology, Acibadem Altunizade Hospital, Istanbul, TUR.
Internal Medicine, Acibadem University, Istanbul, TUR.
Cureus. 2025 Jun 19;17(6):e86384. doi: 10.7759/cureus.86384. eCollection 2025 Jun.
Acute necrotizing pancreatitis is a severe and potentially life-threatening gastrointestinal disease. Walled-off pancreatic necrosis is a serious complication of it. Direct endoscopic necrosectomy (DEN) is considered the first-line therapy. Larger debridement through endoscopy may be both time- and cost-effective, in addition to facilitating faster recovery. Using an endoscopic cap to achieve more necrotic material could be an effective addition to the procedure. A 73-year-old female patient presented with severe abdominal pain, lethargy, and weight loss for the past three months. She was diagnosed with acute necrotizing pancreatitis complicated by an infected walled-off pancreatic necrosis. A total of three, one without and two with cap assistance, DEN procedures were performed. The mean duration of necrosectomy sessions was 52.3 minutes. Large amounts of necrotic material were removed using the endoscopic cap. The patient fully recovered and was discharged without any complications. She is healthy on the six-month follow-up visit. Cap-assisted DEN could be a time- and cost-effective treatment method due to its ability to enable larger debridement.
急性坏死性胰腺炎是一种严重的、可能危及生命的胃肠道疾病。包裹性胰腺坏死是其一种严重并发症。直接内镜坏死组织清除术（DEN）被视为一线治疗方法。除了有助于更快康复外，通过内镜进行更大范围的清创可能在时间和成本方面都更具效益。使用内镜帽获取更多坏死组织可能是该手术的一种有效补充。一名73岁女性患者在过去三个月出现严重腹痛、嗜睡和体重减轻。她被诊断为急性坏死性胰腺炎并发感染性包裹性胰腺坏死。共进行了三次DEN手术，一次无内镜帽辅助，两次有内镜帽辅助。坏死组织清除术的平均时长为52.3分钟。使用内镜帽清除了大量坏死组织。患者完全康复且无任何并发症出院。在六个月的随访中她情况良好。由于内镜帽辅助DEN能够实现更大范围的清创，它可能是一种在时间和成本方面都更具效益的治疗方法。
