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. 2013 Nov 25;13:161. doi: 10.1186/1471-230X-13-161

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Copyright © 2013 van Brunschot et al.; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Endoscopic step-up approach. Endoscopic step-up approach consisting of endoscopic transluminal drainage (ETD) and endoscopic transluminal necrosectomy (ETN). A large peripancreatic collection containing fluid and necrosis is shown. (A) ETD: the collection is punctured through the gastric wall, followed by balloon dilatation of the tract. Two double-pigtail stents and a nasocystic catheter for continuous postoperative irrigation are placed. (B) ETN: the cystostomy tract is dilated, the collection is entered with a endoscope, and necrosectomy is performed. (Reprinted from van Brunschot et al. [11]; copyright 2013, with permission from Elsevier).