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The DOI matches its Crossref record; 2 of the 2 references it cites were found in a registry or an index.

Endoscopic or surgical step-up approach for infected necrotising pancreatitis: a multicentre randomised trial

Open access
van Brunschot, Sandra, van Grinsven, Janneke, van Santvoort, Hjalmar C, Bakker, Olaf J, Besselink, Marc G, Boermeester, Marja A, Bollen, Thomas L, Bosscha, Koop, Bouwense, Stefan A, Bruno, Marco J, Cappendijk, Vincent C, Consten, Esther C, Dejong, Cornelis H, van Eijck, Casper H, Erkelens, Willemien G, van Goor, Harry, van Grevenstein, Wilhelmina M U, Haveman, Jan-Willem, Hofker, Sijbrand H, Jansen, Jeroen M, Laméris, Johan S, van Lienden, Krijn P, Meijssen, Maarten A, Mulder, Chris J, Nieuwenhuijs, Vincent B, Poley, Jan-Werner, Quispel, Rutger, de Ridder, Rogier J, Römkens, Tessa E, Scheepers, Joris J, Schepers, Nicolien J, Schwartz, Matthijs P, Seerden, Tom, Spanier, B W Marcel, Straathof, Jan Willem A, Strijker, Marin, Timmer, Robin, Venneman, Niels G, Vleggaar, Frank P, Voermans, Rogier P, Witteman, Ben J, Gooszen, Hein G, Dijkgraaf, Marcel G, Fockens, Paul, Manusama, Eric R, Hadithi, Mohammed, Rosman, Camiel, Schaapherder, Alexander F, Schoon, Erik J·2018·The Lancet
DOI 10.1016/s0140-6736(17)32404-2
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Abstract

BACKGROUND: Infected necrotising pancreatitis is a potentially lethal disease and an indication for invasive intervention. The surgical step-up approach is the standard treatment. A promising alternative is the endoscopic step-up approach. We compared both approaches to see whether the endoscopic step-up approach was superior to the surgical step-up approach in terms of clinical and economic outcomes. METHODS: In this multicentre, randomised, superiority trial, we recruited adult patients with infected necrotising pancreatitis and an indication for invasive intervention from 19 hospitals in the Netherlands. Patients were randomly assigned to either the endoscopic or the surgical step-up approach. The endoscopic approach consisted of endoscopic ultrasound-guided transluminal drainage followed, if necessary, by endoscopic necrosectomy. The surgical approach consisted of percutaneous catheter drainage followed, if necessary, by video-assisted retroperitoneal debridement. The primary endpoint was a composite of major complications or death during 6-month follow-up. Analyses were by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN09186711. FINDINGS: Between Sept 20, 2011, and Jan 29, 2015, we screened 418 patients with pancreatic or extrapancreatic necrosis, of which 98 patients were enrolled and randomly assigned to the endoscopic step-up approach (n=51) or the surgical step-up approach (n=47). The primary endpoint occurred in 22 (43%) of 51 patients in the endoscopy group and in 21 (45%) of 47 patients in the surgery group (risk ratio [RR] 0·97, 95% CI 0·62-1·51; p=0·88). Mortality did not differ between groups (nine [18%] patients in the endoscopy group vs six [13%] patients in the surgery group; RR 1·38, 95% CI 0·53-3·59, p=0·50), nor did any of the major complications included in the primary endpoint. INTERPRETATION: In patients with infected necrotising pancreatitis, the endoscopic step-up approach was not superior to the surgical step-up approach in reducing major complications or death. The rate of pancreatic fistulas and length of hospital stay were lower in the endoscopy group. The outcome of this trial will probably result in a shift to the endoscopic step-up approach as treatment preference. FUNDING: The Dutch Digestive Disease Foundation, Fonds NutsOhra, and the Netherlands Organization for Health Research and Development.

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Metadata

Authors
van Brunschot, S., van Grinsven, J., van Santvoort, H. C., Bakker, O. J., Besselink, M. G., Boermeester, M. A., Bollen, T. L., Bosscha, K., Bouwense, S. A., Bruno, M. J., Cappendijk, V. C., Consten, E. C., Dejong, C. H., van Eijck, C. H., Erkelens, W. G., van Goor, H., van Grevenstein, W. M. U., Haveman, J.-W., Hofker, S. H., Jansen, J. M., Laméris, J. S., van Lienden, K. P., Meijssen, M. A., Mulder, C. J., Nieuwenhuijs, V. B., Poley, J.-W., Quispel, R., de Ridder, R. J., Römkens, T. E., Scheepers, J. J., Schepers, N. J., Schwartz, M. P., Seerden, T., Spanier, B. W. M., Straathof, J. W. A., Strijker, M., Timmer, R., Venneman, N. G., Vleggaar, F. P., Voermans, R. P., Witteman, B. J., Gooszen, H. G., Dijkgraaf, M. G., Fockens, P., Manusama, E. R., Hadithi, M., Rosman, C., Schaapherder, A. F., & Schoon, E. J.
Venue
The Lancet
Publisher
Elsevier BV
Published
2018-01
Volume
391
Issue
10115
Pages
51-58
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(17)32404-2
OpenAlex
W2766725007
Cited by
739
References
2
FWCI
53.06
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Endoscopic or surgical step-up approach for infected necrotising pancreatitis: a multicentre randomised trial. https://app.cochat.ai/papers/10.1016/s0140-6736(17)32404-2
The paper
van Brunschot, S., van Grinsven, J., van Santvoort, H. C., Bakker, O. J., Besselink, M. G., Boermeester, M. A., Bollen, T. L., Bosscha, K., Bouwense, S. A., Bruno, M. J., Cappendijk, V. C., Consten, E. C., Dejong, C. H., van Eijck, C. H., Erkelens, W. G., van Goor, H., van Grevenstein, W. M. U., Haveman, J.-W., Hofker, S. H., . . . Schoon, E. J. (2018). Endoscopic or surgical step-up approach for infected necrotising pancreatitis: a multicentre randomised trial. The Lancet. https://doi.org/10.1016/s0140-6736(17)32404-2

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.