Trial reportTrials2016
Early biliary decompression versus conservative treatment in acute biliary pancreatitis (APEC trial): study protocol for a randomized controlled trial.
Trial report in Trials, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 50 citations in OpenAlex.
- The therapeutic value of "Bile Transfer" for complications of acute pancreatitis: A retrospective clinical study.Journal of advanced research · 2026Article
- Article
- Phospholipid and glycerolipid metabolism as potential diagnostic biomarkers for acute pancreatitis.Lipids in health and disease · 2024Article
- ERCP improves mortality in acute biliary pancreatitis without cholangitis.Endoscopy international open · 2021Article
- A narrative review of acute pancreatitis and its diagnosis, pathogenetic mechanism, and management.Annals of translational medicine · 2021Review
- Management of Severe Acute Pancreatitis: An Update.Digestion · 2021Review
- Timing of endoscopic therapy for acute bilio-pancreatic diseases: a practical overview.Annals of gastroenterology · 2021Review
- Article
- The diagnostic work-up and outcomes of 'presumed' idiopathic acute pancreatitis: A post-hoc analysis of a multicentre observational cohort.United European gastroenterology journal · 2020Observational
- The Clinical Characteristics of Acute Pancreatitis in Gerontal Patients: A Retrospective Study.Clinical interventions in aging · 2020Article
- New insights into acute pancreatitis.Nature reviews. Gastroenterology & hepatology · 2019Review
- Article
- Risk Stratification and Early Conservative Treatment of Acute Pancreatitis.Visceral medicine · 2019Review
- 2019 WSES guidelines for the management of severe acute pancreatitis.World journal of emergency surgery : WJES · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
40 authors at 20 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute pancreatitis is mostly caused by gallstones or sludge. Early decompression of the biliary tree by endoscopic retrograde cholangiography (ERC) with sphincterotomy may improve outcome in these patients. Whereas current guidelines recommend early ERC in patients with concomitant cholangitis, early ERC is not recommended in patients with mild biliary pancreatitis. Evidence on the role of routine early ERC with endoscopic sphincterotomy in patients without cholangitis but with biliary pancreatitis at high risk for complications is lacking. We hypothesize that early ERC with sphincterotomy improves outcome in these patients. METHODS/
designThe APEC trial is a randomized controlled, parallel group, superiority multicenter trial. Within 24 hours after presentation to the emergency department, patients with biliary pancreatitis without cholangitis and at high risk for complications, based on an Acute Physiology and Chronic Health Evaluation (APACHE-II) score of 8 or greater, Modified Glasgow score of 3 or greater, or serum C-reactive protein above 150 mg/L, will be randomized. In 27 hospitals of the Dutch Pancreatitis Study Group, 232 patients will be allocated to early ERC with sphincterotomy or to conservative treatment. The primary endpoint is a composite of major complications (that is, organ failure, pancreatic necrosis, pneumonia, bacteremia, cholangitis, pancreatic endocrine, or exocrine insufficiency) or death within 180 days after randomization. Secondary endpoints include ERC-related complications, infected necrotizing pancreatitis, length of hospital stay and an economical evaluation. DISCUSSION: The APEC trial investigates whether an early ERC with sphincterotomy reduces the composite endpoint of major complications or death compared with conservative treatment in patients with biliary pancreatitis at high risk of complications.
trial registrationCurrent Controlled Trials ISRCTN97372133 (date registration: 17-12-2012).
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