Endoscopic transluminal pancreatic necrosectomy using a self-expanding metal stent and high-flow water-jet system

Figure 1 Endoscopic treatment of a large walled off pancreatic necrosis. A: Puncture; B: Dilatation; C: Self-expanding metal stent implantation (Case 1).

Figure 2 Endoscopic treatment. Removal of self-expanding metal stent (A, B), endoscopic transluminal necrosectomy (C, D), application of high-flow water-jet system using a flush knife (E, F) (Case 2).

Figure 3 Endoscopic treatment. Endoscopic transluminal necrosectomy (A), application of high-flow water-jet system using a flush knife and hot biopsy forceps (B-D) (Case 3).

Figure 4 Effect of endoscopic transluminal therapy on C-reactive protein levels (first endoscopic intervention at day 0). CRP: C-reactive protein.