Trial reportBMC surgery2006
Minimally invasive 'step-up approach' versus maximal necrosectomy in patients with acute necrotising pancreatitis (PANTER trial): design and rationale of a randomised controlled multicenter trial [ISRCTN13975868].
Trial report in BMC surgery, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06553651 (Necrosectomy With Cryotechnology for Accelerated Removal), which is not on this map. Cited by 70 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Necrosectomy With Cryotechnology for Accelerated Removal
Who cites it
70 citing papers in PubMed, 7 syntheses or guidelines pooled it, 201 citations in OpenAlex.
- SAGES clinical practice guidelines for the management of symptomatic walled-off pancreatic necrosis.Surgical endoscopy · 2026Guideline
- Endoscopic Versus Surgical Management for Infected Necrotizing Pancreatitis and Walled-Off Necrosis: A Systematic Review of Randomized Controlled Trials.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Open necrosectomy is feasible as a last resort in selected cases with infected pancreatic necrosis: a case series and systematic literature review.World journal of emergency surgery : WJES · 2020Pooled it
- Combined totally mini-invasive approach in necrotizing pancreatitis: a case report and systematic literature review.World journal of emergency surgery : WJES · 2017Pooled it
- Interventions for necrotising pancreatitis.The Cochrane database of systematic reviews · 2016Pooled it
- Endoscopic transluminal necrosectomy in necrotising pancreatitis: a systematic review.Surgical endoscopy · 2014Pooled it
- Minimally invasive management of pancreatic abscess, pseudocyst, and necrosis: a systematic review of current guidelines.World journal of surgery · 2008Pooled it
- Trial
- Hydrogen peroxide-assisted endoscopic necrosectomy for walled-off pancreatic necrosis: a dual center pilot experience.Digestive diseases and sciences · 2014Trial
- Trial
- Management and Prediction of Acute Pancreatitis Severity Using AI: A Surgical Perspective.Diagnostics (Basel, Switzerland) · 2026Review
- Has the Step-Up Approach Improved Prognosis in Severe Necrotizing Acute Pancreatitis?Journal of clinical medicine · 2026Article
- Splanchnic venous thrombosis in necrotizing pancreatitis: recanalization and the effectiveness of anticoagulant therapy.World journal of emergency surgery : WJES · 2026Article
- Surgery for necrotizing acute pancreatitis: surgical approach, morbidity and challenges encountered: experience from a tertiary care hepatopancreatobiliary unit in Sri Lanka.Frontiers in surgery · 2026Article
- Minimally invasive approach versus open approach in the management of necrotizing acute pancreatitis: A systematic review and meta-analysis.Annals of hepato-biliary-pancreatic surgery · 2025Review
- Article
- Risk Factors Influencing Mortality in Open Necrosectomy for Acute Pancreatitis: A Comparative Analysis.Journal of clinical medicine · 2024Article
- Turkish Society of Gastroenterology: Pancreas Working Group, Acute Pancreatitis Committee Consensus Report.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2024Review
- Effective percutaneous treatment of severe necrotizing pancreatitis: a case report.Journal of surgical case reports · 2024Article
- Review
10 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
32 authors at 20 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe initial treatment of acute necrotizing pancreatitis is conservative. Intervention is indicated in patients with (suspected) infected necrotizing pancreatitis. In the Netherlands, the standard intervention is necrosectomy by laparotomy followed by continuous postoperative lavage (CPL). In recent years several minimally invasive strategies have been introduced. So far, these strategies have never been compared in a randomised controlled trial. The PANTER study (PAncreatitis, Necrosectomy versus sTEp up appRoach) was conceived to yield the evidence needed for a considered policy decision. METHODS/
design88 patients with (suspected) infected necrotizing pancreatitis will be randomly allocated to either group A) minimally invasive 'step-up approach' starting with drainage followed, if necessary, by videoscopic assisted retroperitoneal debridement (VARD) or group B) maximal necrosectomy by laparotomy. Both procedures are followed by CPL. Patients will be recruited from 20 hospitals, including all Dutch university medical centres, over a 3-year period. The primary endpoint is the proportion of patients suffering from postoperative major morbidity and mortality. Secondary endpoints are complications, new onset sepsis, length of hospital and intensive care stay, quality of life and total (direct and indirect) costs. To demonstrate that the 'step-up approach' can reduce the major morbidity and mortality rate from 45 to 16%, with 80% power at 5% alpha, a total sample size of 88 patients was calculated. DISCUSSION: The PANTER-study is a randomised controlled trial that will provide evidence on the merits of a minimally invasive 'step-up approach' in patients with (suspected) infected necrotizing pancreatitis.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.