S381 Retrieving an Endoscopic Cap From the Submucosal Tunnel During a POEM Procedure: Keep an Eye on the Cap Before Closing the Mucosal Incision

Abstract

Introduction: Walled Off Pancreatic Necrosis (WOPN) is a result of acute pancreatitis. These cyst cavities have been traditionally drained via an open surgical approaches. More modern approaches with endoscopic drainage and debridment are used effectively for pancreatic pseudocysts and have been used for WOPN. These cases usually require several debridment procedures per patient. Evolution of surgical approaches with less invasive approaches continue to evolve. Case Description/Methods: This video demonstrates a combined endoscopic and laparoscopic approach to debridment of a walled odd pancreatic necrosis through the posterior gastric wall. This approach we have termed "Lap TEC" stands for Laparoscopic Transgastric Endoscopically assisted Cystgastrostomy for a woman several months from an episode of acute pancreatitis resulting in a large symptomatic WOPN. Discussion: Lap TEC is an effective approach for patients with walled off pancreatic necrosis. These patient should be managed by a multidisciplinary team including gastroenterologists and surgeons. Approach chosen for management of WOPN should include patient risk factors, size and location of WOPN, amount of cavitary debris and local expertise. Lap TEC has demonstrated a high degree of safety and efficacy for patient requiring debridment and drainage of WOPN. Watch the video at https://tinyurl.com/ACGAbstractS380