Immediate versus Postponed Intervention for Infected Necrotizing Pancreatitis

• Published in: The New England journal of medicine Vol. 385; no. 15; pp. 1372 - 1381
• Main Authors: Boxhoorn, Lotte, van Dijk, Sven M, van Grinsven, Janneke, Verdonk, Robert C, Boermeester, Marja A, Bollen, Thomas L, Bouwense, Stefan A.W, Bruno, Marco J, Cappendijk, Vincent C, Dejong, Cornelis H.C, van Duijvendijk, Peter, van Eijck, Casper H.J, Fockens, Paul, Francken, Michiel F.G, van Goor, Harry, Hadithi, Muhammed, Hallensleben, Nora D.L, Haveman, Jan Willem, Jacobs, Maarten A.J.M, Jansen, Jeroen M, Kop, Marnix P.M, van Lienden, Krijn P, Manusama, Eric R, Mieog, J. Sven D, Molenaar, I. Quintus, Nieuwenhuijs, Vincent B, Poen, Alexander C, Poley, Jan-Werner, van de Poll, Marcel, Quispel, Rutger, Römkens, Tessa E.H, Schwartz, Matthijs P, Seerden, Tom C, Stommel, Martijn W.J, Straathof, Jan Willem A, Timmerhuis, Hester C, Venneman, Niels G, Voermans, Rogier P, van de Vrie, Wim, Witteman, Ben J, Dijkgraaf, Marcel G.W, van Santvoort, Hjalmar C, Besselink, Marc G
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 07.10.2021
• Subjects: Abdomen; Aged; Anti-Bacterial Agents - therapeutic use; Antibiotics; Catheters; Classification; Clinical Practice; Combined Modality Therapy; Confidence intervals; Drainage; Endoscopy; Female; Fistula; Gastroenterology; Gastroenterology General; Hospital costs; Hospitalist; Humans; Infections; Infectious Disease; Infectious Disease General; Intensive care; Intervention; Length of Stay; Male; Middle Aged; Necrosis; Pancreas - pathology; Pancreas - surgery; Pancreatitis; Pancreatitis, Acute Necrotizing - drug therapy; Pancreatitis, Acute Necrotizing - pathology; Pancreatitis, Acute Necrotizing - surgery; Pancreatitis, Acute Necrotizing - therapy; Patient safety; Primary Care; Surgery; Surgery General; Surgical drains; Time-to-Treatment; Wound drainage
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa2100826

A multicenter, randomized trial of patients with infected necrotizing pancreatitis evaluated immediate drainage within 24 hours after infected necrosis was diagnosed as compared with postponed drainage. Immediate drainage was not superior to postponed drainage in reducing complications. Patients assigned to immediate drainage underwent a greater number of invasive procedures.