Introduction : Video-assisted minimally invasive debridement is gradually accepted in treatment of infected pancreatic necrosis(IPN). Here we reported our experience of IPN debridement assisted by laparoscopy.

Methods : IPN patients underwent laparoscopy assisted debridement were enrolled in this cohort study. Trans-lesser sac or retroperitoneal approach was used according to the abscess spread site. Necrotic cavity lavage was not performed routinely in our center. Overall mortality and complication rate were recorded as major outcome. Multivariable regression was performed to find the risk factors for poor outcome.

Results : From January 2012 to December 2017, we enrolled 104 patients with an average age of 50.17?4.72 years. Of these patients, 81.7%(84/104) were referred from other hospitals, and average time from onset of the disease to referral was 39.4?.2 days. There were 38 and 54 patients received trans-lesser sac and retroperitoneal approach, respectively. Combined approaches were used in 12 patients. No conversion to laparotomy patient. The complication rate was 17.3%(18/104), including new onset of organ dysfunction, pancreatic fistula, abdominal or retroperitoneal hemorrhage and digestive tract fistula. The overall mortality rate was 6.73% (7/104). Risk factors, analyzed by multivariable regression, for poor outcome were Acute Physiology and Chronic Health Enquiry (APACHE)-II score and C-reactive protein on the 7th day after the last operation.

Conclusions : Laparoscopy assisted debridement is safe and effective for IPN patients.