Khamar Jaha Banu*, Natasha Mathias and Nameera Tabassum
Introduction: Walled-Off Pancreatic Necrosis (WOPN) develops in approximately 1-9% of patients following acute pancreatitis, typically manifesting 4-6 weeks after the initial episode. Around 15% of patients with severe necrotising pancreatitis go on to develop WOPN. This condition is associated with significant morbidity and occasional mortality. Most necrotic collections ultimately require intervention-either percutaneous, endoscopic, or surgical.
Materials and Methods: A prospective study was conducted involving 51 patients diagnosed with WOPN. Of these, 23 patients underwent open transgastric drainage, while 28 underwent laparoscopic drainage. Demographic data, intraoperative and postoperative outcomes were analysed and compared between the two groups.
Results: Overall, in our study comparing the open versus laparoscopic approach for transgastric drainage of WOPN, the significant finding was a shorter operative time with the open approach. This can be attributed to the use of intracorporeal suturing rather than staplers. Blood loss was lower in the laparoscopic group. Postoperative infections were more common in the open approach. Mortality and morbidity were similar in both groups; hospital stay was significantly shorter in the laparoscopic group.
Conclusion: No single approach is currently considered the gold standard. Therefore, management must be individualised based on the patient’s clinical presentation and available resources. The laparoscopic approach reduces overall complications, particularly infectious complications. The use of staplers may also significantly reduce operative time. A robotic approach may be best, but due to limited avail ability in remote areas, the laparoscopic approach may be considered.
Published Date: 2026-06-25; Received Date: 2026-05-25
