The patient is a 77 year old female with a past medical history of diabetes mellitus on insulin presenting with gallstone pancreatitis and subsequent necrotizing pancreatitis about 2 weeks prior to presentation to our institution. She initially presented there and improved and returned home before returning to the emergency department there with fevers, abdominal pain and hypotension. A CT scan of her abdomen demonstrated a large area of wall-ed off pancreatic necrosis with air indicating infection. She was in septic shock on presentation to our institution, and underwent percutaneous drainage of her collections via a left sided retroperitoneal route for source control. As part of a dual-modality approach, a transgastric stent was also placed to facilitate drainage of her extensive necrosis. However, there were dense necrotic tissue which were difficult to remove endoscopically and will likely require numerous attempts. Given that she already had percutaneous access, we expedited the debridement by performing a sinus tract endoscopic debridement of the necrosis. The operation was uncomplicated. Two weeks after debridement, a follow-up CT scan demonstrated full resolution of her necrosis, and her external drain was removed. She was seen again postoperatively at 3 months with no recurrence or need for further re-interventions.