ArticleTrials2020
Care after pancreatic resection according to an algorithm for early detection and minimally invasive management of pancreatic fistula versus current practice (PORSCH-trial): design and rationale of a nationwide stepped-wedge cluster-randomized trial.
Article in Trials, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Pooled it
- Completion pancreatectomy or a pancreas-preserving procedure during relaparotomy for pancreatic fistula after pancreatoduodenectomy: a multicentre cohort study and meta-analysis.The British journal of surgery · 2021Pooled it
- Postpancreatectomy acute pancreatitis after distal pancreatectomy: tri-institutional international cohort.BJS open · 2026Article
- The breaking point in robotic pancreaticoduodenectomy: factors influencing conversion thresholds and early postoperative outcomes in a tertiary referral center.Surgical endoscopy · 2026Article
- Article
- Radiological Assessment After Pancreaticoduodenectomy for a Precision Approach to Managing Complications: A Narrative Review.Journal of personalized medicine · 2025Review
- Predictors of Financial Toxicity Trajectories in Patients With Pancreatic Cancer: A Latent Class Growth Analysis.Cancer medicine · 2025Observational
- Total pancreatectomy in patients at high risk of postoperative pancreatic fistula (POPF).Gland surgery · 2024Article
- The role of clinically relevant intra-abdominal collections after pancreaticoduodenectomy : Clinical impact and predictors. A retrospective analysis from a European tertiary centre.Langenbeck's archives of surgery · 2023Article
- Surgical Outcome After Pancreatoduodenectomy for Duodenal Adenocarcinoma Compared with Other Periampullary Cancers: A Nationwide Audit Study.Annals of surgical oncology · 2023Article
- Impact of shifting from laparoscopic to robotic surgery during 600 minimally invasive pancreatic and liver resections.Surgical endoscopy · 2023Article
- Article
- Review
- Risk factors and socio-economic burden in pancreatic ductal adenocarcinoma operation: a machine learning based analysis.BMC cancer · 2020Article
Corrections and comments
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Authors and funding
32 authors at 12 institutions in 1 country.
Funding
Abstract
backgroundPancreatic resection is a major abdominal operation with 50% risk of postoperative complications. A common complication is pancreatic fistula, which may have severe clinical consequences such as postoperative bleeding, organ failure and death. The objective of this study is to investigate whether implementation of an algorithm for early detection and minimally invasive management of pancreatic fistula may improve outcomes after pancreatic resection.
methodsThis is a nationwide stepped-wedge, cluster-randomized, superiority trial, designed in adherence to the Consolidated Standards of Reporting Trials (CONSORT) guidelines. During a period of 22 months, all Dutch centers performing pancreatic surgery will cross over in a randomized order from current practice to best practice according to the algorithm. This evidence-based and consensus-based algorithm will provide daily multilevel advice on the management of patients after pancreatic resection (i.e. indication for abdominal imaging, antibiotic treatment, percutaneous drainage and removal of abdominal drains). The algorithm is designed to aid early detection and minimally invasive step-up management of postoperative pancreatic fistula. Outcomes of current practice will be compared with outcomes after implementation of the algorithm. The primary outcome is a composite of major complications (i.e. post-pancreatectomy bleeding, new-onset organ failure and death) and will be measured in a sample size of at least 1600 patients undergoing pancreatic resection. Secondary endpoints include the individual components of the primary endpoint and other clinical outcomes, healthcare resource utilization and costs analysis. Follow up will be up to 90 days after pancreatic resection. DISCUSSION: It is hypothesized that a structured nationwide implementation of a dedicated algorithm for early detection and minimally invasive step-up management of postoperative pancreatic fistula will reduce the risk of major complications and death after pancreatic resection, as compared to current practice.
trial registrationNetherlands Trial Register: NL 6671. Registered on 16 December 2017.
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Registered trials
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