Evidence map›Paper›PMID 35639137›Full record

ReviewLangenbeck's archives of surgery2022

A "tailored" interventional and surgical management for moderate to critical acute pancreatitis in late phase: a cohort study.

Giulio Di Candio, Simone Guadagni, Niccolò Furbetta, Desirée Gianardi, Matteo Palmeri, Gregorio Di Franco, Matteo Bianchini, Dario Gambaccini, Emanuele Marciano, Rosa Cervelli and 2 more

Registry-linked trialAbstract readReview
PubMed Publisher
In one paragraph

Review in Langenbeck's archives of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04870268 (A Tailored Step-up Approach for Moderate to Critical Acute Pancreatitis in the Late Phase), which is not on this map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.7field-weighted citation impact, top 32% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT04870268 completednot on this map

A Tailored Step-up Approach for Moderate to Critical Acute Pancreatitis in the Late Phase: a Cohort Study

Typeobservational_patient_registrySponsorUniversity of PisaRan2012 to 2021Enrolled47ConditionsAcute PancreatitisArmspercutaneous drainage, endoscopic approach, surgical internal derivation of WON, surgical necrosectomy
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Giulio Di CandioGeneral Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
Simone GuadagniGeneral Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy. s.guadagni@ao-pisa.toscana.it.ORCID http://orcid.org/0000-0001-9072-8166
Niccolò FurbettaGeneral Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
Desirée GianardiGeneral Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
Matteo PalmeriGeneral Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
Gregorio Di FrancoGeneral Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
Matteo BianchiniGeneral Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
Dario GambacciniInterventional and Pediatric Endoscopic Unit, Department of Surgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Emanuele MarcianoInterventional and Pediatric Endoscopic Unit, Department of Surgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Rosa CervelliInterventional Radiology Division, Imaging Department, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Santino MarchiGastroenterology Unit, University of Pisa, Pisa, Italy.
Luca MorelliGeneral Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
University of Pisa · ITAzienda Ospedaliera Universitaria Pisana · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSeveral interventional procedures are available to treat moderate-to-critical acute pancreatitis (AP) in its late phase. The ongoing debate on these options, together with the scarcity of reported quality of life (QoL) information in the Literature, prompted us to conduct a review of our experience.

methodsAll the patients treated at our referral Center for moderate-to-critical AP according to Determinant-Based Classification (DBC) were retrospectively reviewed. Patients treated conservatively or operated within 4 weeks were excluded. The included patients were managed following a "tailored" interventional-surgical approach, which did not exclude the possibility to skip one or more steps of the classic "step-up" approach, based on the patient's clinical course, and divided into four groups, according to the first procedure performed: percutaneous drainage (PD), endoscopic approach (END), internal derivation (INT), and necrosectomy (NE). In-hospital and mid-term follow-up variables were analyzed.

resultsThe study sample consisted in 47 patients: 11 patients were treated by PD, 11 by END, 13 by INT, and 12 by NE. A significant distribution of the DBC severity (p = 0.029) was registered among the four groups. Moreover, the NE group had statistically significant reduced SF-36 scores in the domain of social functioning at 3 months (p = 0.011), at 1 year (p = 0.002), and at 2 years (p = 0.001); role limitations due to physical health at 6 months (p = 0.027); and role limitations due to emotional problems at 1 year (p = 0.020).

conclusionsIn the "late phase" of moderate to critical AP requiring an invasive management, PD, END, INT, and NE are all effective options, depending on patents' status and necrosis location. A "tailored" interventional-surgical management could be pursued, but up-front more invasive approaches are at higher risk of worse QoL.

trial registrationThe manuscript was registered at clinicaltrials.gov in 04/2021 and identified with NCT04870268.

Indexed as

Pancreatitis, Acute NecrotizingAcute DiseaseCohort StudiesDrainageHumansQuality of LifeRetrospective StudiesAcute pancreatitisQuality of lifeSurgical treatmentWalled-off necrosis

Identifiers

PMID35639137
OpenAlexW4281773612

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.