*4.2.3.2 Surgical transgastric debridement*

The concept is similar to endoscopic trasngastic drainage. It can be performed by open or laparoscopic approach. An anterior gastrostomy is required to access the posterior face of the stomach and then the infected cavity. It is especially useful in central collections that do not affect the flanks (**Figure 10**). It is advisable to leave a drain inside the cavity for washing. There are studies of small sample size that demonstrate the efficacy of the technique with low morbidity [33–35].

**Figure 10.** *CT scan image showing collection near the gastric posterior wall that would allow a transgastic approach.*
