Laparoscopic transgastric necrosectomy may outperform endoscopic approach.

• Study found similar 30-day readmission (23% vs 25%) and mortality rates (3% for both).
• Median total debridement time was comparable (131 min for LTN vs 134 min for DEN), but complete debridement was achieved more often with DEN (3 times vs 1).
• LTN reduced length of stay for patients with higher APACHE II scores (8 vs 10 days).

This suggests LTN could be the preferred choice for managing walled-off necrosis in select patients.