Drain Irrigation with Vacuum Assistance Necrosectomy in Necrotizing Pancreatitis
Stella Chen1, Ian W Sullivan2, Nathan E Frenk2
1Tufts University School of Medicine, Boston, Massachusetts.
Journal of Vascular and Interventional Radiology : JVIR
|January 24, 2026
Summary
Drain Irrigation with Vacuum Assistance (DIVA) necrosectomy offers faster resolution for necrotizing pancreatitis patients. This novel approach shows promise despite higher initial disease severity, warranting further investigation.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Minimally Invasive Procedures
Background:
- Necrotizing pancreatitis presents significant treatment challenges.
- Minimally invasive necrosectomy aims to improve patient outcomes.
- Traditional methods include VARD and ETN.
Purpose of the Study:
- To compare a novel percutaneous approach, Drain Irrigation with Vacuum Assistance (DIVA) necrosectomy, with traditional minimally invasive treatments for necrotizing pancreatitis.
- To evaluate the efficacy and safety of DIVA necrosectomy.
Main Methods:
- Retrospective single-center study of 20 patients with necrotizing pancreatitis.
- Comparison between DIVA (n=6) and VARD/ETN (n=14) groups.
- Analysis of procedure count, time to resolution, and adverse events.
Main Results:
- DIVA patients presented with higher disease severity (APACHE II score 15.0 vs 6.5, p=0.012).
- DIVA achieved faster resolution of fluid collections (48.8 days vs 110.1 days, p=0.017).
- Higher resolution rate in DIVA group (100% vs 86%) with a trend towards fewer adverse events.
Conclusions:
- Image-guided DIVA necrosectomy demonstrates faster resolution in necrotizing pancreatitis compared to VARD/ETN.
- DIVA is a promising alternative for treating necrotizing pancreatitis, even in severe cases.
- Further research is recommended to establish DIVA's role in clinical practice.
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