Fig. 2

Endoscopic view of the stomach with a post-operative pancreatogastric dehiscence (PGD). All pictures refer to the same patient (“patient no. 1”). A PGD at first endoscopic encounter (day 0). B View through the PGD into the PGD-associated retrogastral wound cavity containing percutaneous wound drainage (day 0). C Intracavitary position of a polyurethane foam sponge. A vacuum pump applies continuous suction to the sponge through a 16Fr catheter. The percutaneous wound drainage has been partially withdrawn to not interfere with the endoscopic vacuum therapy (EVT). D Ongoing EVT unmasked a large retrogastral necrotic wound cavity (day 15 of EVT). The PGD channel had to be dilated with a 10 mm dilation balloon four days earlier to permit direct endoscopic necrosectomy (DEN) and facilitate sufficient insertion of the sponge into the cavity. E Wound cavity on the last day of continuous EVT. EVT was successfully ended after 29 days. F Entirely closed PGD seven weeks later