【Abstract】Objective To compare the efficacy of transnasal gastrosope and conventional gastroscope in the treatment of infective pancreatic necrosis（IPN） through percutaneous endoscopic necrosectomy(PEN). Methods The clinical data of 24 IPN patients who received PEN treatment for peripancreatic abscess from December 2015 to March 2019 were retrospectively analyzed, which were divided into the conventional gastroscopy group (n=15) and the transnasal gastroscopy group (n=9). The clinical therapeutic indicators of the two groups such as vital signs, APACHEII score changes, surgery frequency, operation duration,difference value in preoperative and postoperative volumes, complications (such as bleeding, pancreatic fistula, infection, etc.), postoperative recovery time, postoperative average daily cost, prognosis and other indicators were compared between the two groups.Results. There was no significant difference in age, gender, etiology, number of drainage tubes, operation frequency, preoperative APACHEII score, preoperative peripancreatic necrotic volume, postoperative recovery time and mortality between the conventional gastroscopy group and the transnasal gastroscopy group (P>0.05). There was also no statistically significant difference in the variation curve fitting of APACHE II score between the two groups (t=0.378, P=0.710).The operative time of the transnasal gastroscopy group was significantly better than that of the conventional gastroscopy group (119.7±47.4min vs 172.8±56.2min, P=0.018).There was a significant decrease in peripancreatic necrotic volume in the transnasal gastroscopy group(468.9±137.37ml vs 404.03±170.73ml,P=0.002), and in the conventional gastroscopy group(722.50±292.96ml vs 499.44±227.17ml,P<0.001). There was no statistically significant difference in the preoperative and postoperative peripancreatic necrotic volume deviation between the two groups (223.06±212.92ml vs 64.87±54.94ml,P = 0.094).Conclusion On the condition of poor drainage effect of PCD, the "up-stage approach" such as PEN can significantly reduce the range of necrotic lesions. Nasogastriscope has the advantages of shorter duration in PEN surgery and the ability to clear deep abscess cavities than conventional gastroscopy.