LAUSR

Severe acute pancreatitis often causes walled-off necrosis (WON). Despite recent reports of endoscopic transgastric necrosectomy using a lumen-apposing metal stent [1, 2], treatment strategies for WON remain challenging. A 53-year-oldmanwith recurrence of ampullary adenoma underwent endoscopic treatment with argon plasma coagulation. Severe acute pancreatitis developed, which was managed conservatively. Four weeks later, the patient presented with fever, abdominal pain, and a significant rise in C-reactive protein. Contrast-enhanced computed tomography (CE-CT) revealed extensive pancreatic necrosis and acute necrotic collections (▶Fig. 1). Percutaneous drainage of the left subphrenic space was performed initially using a 12-Fr tube due to insufficient encapsulation. Then, we performed E-Videos