Long term outcome after endoscopic treatment of necrosis due to pancreatitis.

Transluminal endoscopic necrosectomy: 1)transgastric or transduodenal access to the retroperitoneal cavity using endoscopic or endosonographic guidance. 2)balloon dilation of the access was carried out to permit the introduction of a conventional gastroscope to allow forceful irrigation and suction, as well as active endoscopic removal of debris using snares, forceps, and stone removal baskets. 3)Repeated sessions at intervals of 1–4 days were carried out until all debris and necrotic material had been removed and the walls of the collections could be seen as vital structures. The duration of a session was determined mainly by patient tolerance of sedation or general anesthesia, but was usually limited to 90 minutes.