• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Emergency

Immediate drainage of infected necrotizing pancreatitis shows no benefit over postponed drainage

byBoaz WongandHarsh Shah
February 14, 2022
in Emergency, Gastroenterology, Infectious Disease, Surgery
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. Patients who underwent catheter drainage for infected necrotizing pancreatitis did not experience better post-interventional outcomes compared to postponed drainage.

2. Patients who underwent postponed drainage required fewer invasive interventions.

Evidence Rating Level: 1 (Excellent)   

Study Rundown: Infected necrotizing pancreatitis often requires interventional treatment of catheter drainage and antibiotic administration. However, the therapeutic benefit of the timing of this drainage to be performed at diagnosis, compared to after the infection has encapsulated, is unclear. In this randomized controlled trial, 104 patients with infected necrotizing pancreatitis were randomized to either receive immediate or postponed catheter drainage. The therapeutic efficacy of the intervention was primarily measured using the Comprehensive Complication Index (CCI) The study found no differences in mean CCI scores or mortality between the two groups. Moreover, the cohort receiving postponed drainage experienced fewer interventional treatments (subsequent catheter drainage or necrosectomy) compared to the immediate drainage group. The results of this study were primarily limited by the measure of complications, as the CCI is primarily used to measure postoperative complications where some factors may not be clinically relevant. The study also did not differentiate between endoscopic from surgical drainage events, which may influence the efficacy of the intervention. Together, this study found no benefit in therapeutic outcomes in infected necrotizing pancreatitis patients receiving immediate catheter drainage compared to those treated with a more conservative postponed drainage approach.

Click to read the study in NEJM

Relevant Reading: Timing of surgical intervention in necrotizing pancreatitis

In-Depth [randomized controlled trial]: In this multi-center, randomized controlled trial, 932 patients with necrotizing pancreatitis were assessed. Patients were enrolled in the trial if they had an infection confirmed by imaging, or by Gram’s stain or culture from a biopsy sample. Patients were randomized in a 1:1 ratio to either receive immediate catheter drainage and antibiotics upon diagnosis or postponed intervention until encapsulated necrosis was observed. Additional interventions including catheter tube replacement or necrosectomy were considered if clinical improvement was not observed within 72 hours of intervention. For the primary outcome, patients were followed for 6 months for improvements in clinical complications, which was measured as a Comprehensive Complication Index (CCI) score. Secondary outcomes included mortality rate, number of interventions, and incidence of major complications. The study found no differences in mean CCI score between the immediate (CCI score, 57; 95% confidence interval [CI], 50-65) and the postponed drainage group (CCI score, 58; 95% CI, 50-67). No differences were found in mortality rate (relative risk [RR], 1.25; 95% CI, 0.42-3.68) or major complications (RR, 0.94; 95% CI, 0.77-1.14). However, for interventions, the immediate drainage group had a higher average number of interventions (4.4 vs. 2.6), increased risk for necrosectomy (RR, 2.27; 95% CI 1.27-4.06 ). In fact, 19 (39%) patients treated conservatively did not receive catheter drainage because they improved from antibiotic therapy alone. Overall, this study demonstrates that while immediate drainage did not negatively impact outcomes but may increase the necessity of more therapeutic interventions compared to postponed drainage. Accordingly, a conservative approach first utilizing a course of antibiotics is supported.

RELATED REPORTS

The Scan by 2 Minute Medicine®: Overprescribed and Understocked, A Costly Message, A Bad Wrap and Mauna Loa Erupts Again!

#VisualAbstract: Shorter antibiotic course non-inferior to longer course for pediatric community-acquired pneumonia

Virtual pediatric acute care visits within the medical home are safe and acceptable to parents

Image: PD

©2022 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: antibioticsimmediate drainageinfected necrotizing pancreatitispancreatitispostponed drainage
Previous Post

Oral HIV preexposure prophylaxis limits willingness to pay for long-acting injectable prophylaxis

Next Post

Cemiplimab treatment of recurrent cervical cancer is associated with longer overall survival

RelatedReports

The Scan by 2 Minute Medicine®:  Ultra-Trail du Mont-Blanc, Taylor Swift, NBA rookie Chet Holmgren and Magic Mushrooms!
The Scan by 2 Minute Medicine®

The Scan by 2 Minute Medicine®: Overprescribed and Understocked, A Costly Message, A Bad Wrap and Mauna Loa Erupts Again!

December 14, 2022
#VisualAbstract: Intensive blood pressure control post-endovascular thrombectomy after acute ischemic stroke linked with worse clinical outcomes
StudyGraphics

#VisualAbstract: Shorter antibiotic course non-inferior to longer course for pediatric community-acquired pneumonia

November 25, 2022
AAP recommends telemedicine to improve access to care
Emergency

Virtual pediatric acute care visits within the medical home are safe and acceptable to parents

November 25, 2022
#VisualAbstract: Cefepime and Enmetazobactam in treatment of urinary tract infection or acute pyelonephritis was more effective than Piperacillin and Tazobactam
StudyGraphics

#VisualAbstract: Cefepime and Enmetazobactam in treatment of urinary tract infection or acute pyelonephritis was more effective than Piperacillin and Tazobactam

October 6, 2022
Next Post
Patient Basics: Cervical Cancer

Cemiplimab treatment of recurrent cervical cancer is associated with longer overall survival

2 Minute Medicine Rewind October 12 – 19, 2014

Absence of coronary plaque among symptomatic patients with high low-density lipoprotein cholesterol levels associated with low risk of atherosclerotic cardiovascular disease events

Children’s hospital visits for suicide ideation and attempts are increasing

The relationship between mental health and religiosity may not be bi-directional

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Higher body mass index may be associated with altered vitamin D levels and metabolism
  • #VisualAbstract: Torsemide does not provide additional decrease in mortality compared to furosemide among patients hospitalized for heart failure
  • Community-based adult vision screening program increases access to eye care
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options