• 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 The Classics General Medicine Classics

The PANTER trial: Open necrosectomy vs step-up approach for necrotizing pancreatitis [Classics Series]

byLauren KoandAndrew Cheung, MD MBA
March 25, 2014
in General Medicine Classics, Surgery Classics, The Classics
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

Image: PD

1. A minimally invasive step-up approach significantly reduced the rate of major complications as compared to open necrosectomy in patients with necrotizing pancreatitis

Original Date of Publication: April 22, 2010

Study Rundown: Necrotizing pancreatitis with infected necrotic tissue is associated with high rates of both complication and death. Though first-line treatment is open necrosectomy, this study compares this with a minimally invasive step-up approach, consisting of percutaneous drainage, endoscopic drainage, and/or minimally invasive retroperotineal necrosectomy. The incidence of multiple organ failure was significantly lower in patients who underwent the step-up approach compared with those who had open necrosectomy. Though the rate of death did not differ significantly between the two groups, patients who were assigned to the step-up approach faced significantly lower rates of both incisional hernias and new-onset diabetes. One limitation of the study was that it was not powered to detect significant differences in death between the two groups.

Click to read the study in NEJM

In-Depth [randomized, controlled study]: Originally published in NEJM in 2010, this multicenter, randomized, controlled study involved 88 patients with acute pancreatitis and pancreatic necrosis. They were randomized to receive treatment with either open necrosectomy or a step-up approach, which included percutaneous or endoscopic drainage, and minimally invasive retroperitoneal necrosectomy. The primary end point was a composite of complications (i.e., new-onset multiple-organ failure, multiple systemic complications, bleeding, perforation of a visceral organ) and death. Patients managed using the step-up approach experienced a significantly lower rate of the composite primary end point compared to those treated with open necrosectomy (RR 0.57; 95%CI 0.38-0.87). This was largely driven by a significant reduction in new-onset organ failure (12% vs. 40%, P=0.002), as there was no significant difference between the two groups in mortality. After six months of follow-up, patients who underwent open necrosectomy had a higher rate of incisional hernias (RR 0.29; 95%CI 0.09-0.95), new-onset diabetes (RR 0.43; 95%CI 0.20-0.94) and use of pancreatic enzymes (RR 0.21; 95%CI 0.07-0.67) when compared to those treated with the step-up approach. The study suggests that when treating necrotizing pancreatitis patients, a minimally invasive step-up approach reduces the rate of major complications and long-term complications when compared to open necrosectomy.

© 2012-2014 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain.

RELATED REPORTS

2 Minute Medicine Rewind November 17 – November 23, 2014

Early tube feeding unable to reduce infections in pancreatitis [PYTHON trial]

Somatostatin may not reduce risk of pancreatitis post endoscopic retrograde cholangiopancreatography

Tags: pancreatitits
Previous Post

Cerclage outcomes similar in singleton and twin pregnancies

Next Post

Chlorhexidine may not benefit intubated non-cardiac surgery patients

RelatedReports

Dexamethasone shows comparable efficacy to prednisone/prednisolone in pediatric asthma
Cardiology

2 Minute Medicine Rewind November 17 – November 23, 2014

November 27, 2014
Early tube feeding unable to reduce infections in pancreatitis [PYTHON trial]
Chronic Disease

Early tube feeding unable to reduce infections in pancreatitis [PYTHON trial]

November 20, 2014
Somatostatin may not reduce risk of pancreatitis post endoscopic retrograde cholangiopancreatography
Chronic Disease

Somatostatin may not reduce risk of pancreatitis post endoscopic retrograde cholangiopancreatography

July 4, 2014
Next Post
Home scoring system may prevent unnecessary pharyngitis clinic visits

Chlorhexidine may not benefit intubated non-cardiac surgery patients

Dementia prevalence declining in the UK

Insufficient evidence for dementia screening tests in older adults

Lower vulvar cancer-related mortality in African Americans

Distance to Veterans Affairs Transplant Center affects likelihood of liver transplantation

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

  • Momelotinib reduces symptom burden compared to danazol in patients with myelofibrosis
  • Machine renal perfusion reduces delayed graft function after transplantation
  • COVID-19 mRNA vaccines are safe and effective in children aged 5 to 11 years
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