SynthesisWorld journal of emergency surgery : WJES2023
The optimal timing and intervention to reduce mortality for necrotizing pancreatitis: a systematic review and network meta-analysis.
Synthesis in World journal of emergency surgery : WJES, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- SAGES systematic review and meta-analysis for the management of symptomatic walled-off pancreatic necrosis.Surgical endoscopy · 2026Pooled it
- The short-term and long-term clinical outcomes from early versus delayed minimally invasive intervention for acute necrotic collections in necrotizing pancreatitis: a systematic review and meta-analysis.International journal of surgery (London, England) · 2026Pooled it
- Endoscopic versus minimally invasive surgical approach for infected necrotizing pancreatitis: a systematic review and meta-analysis of randomized controlled trials.Annals of medicine · 2023Pooled it
- Percutaneous Endoscopic Necrosectomy of Walled-Off Pancreatic and Peripancreatic Necrosis.Journal of clinical medicine · 2026Article
- Guidelines for endoscopic treatment of postinflammatory pancreatic and peripancreatic fluid collections. Recommendations of the Endoscopic Surgery Section of the Association of Polish Surgeons, the Endoscopy Section of the Polish Society of Gastroenterology, the Polish Pancreatic Club, the Laparoscopic and Robotic Surgery Section of the Association of Polish Surgeons, and the Pancreatic Surgery Section of the Association of Polish Surgeons; formulated by an expert panel led by Prof. Mateusz Jagielski, MD, PhD.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2025Review
- Application and Value of Percutaneous Catheter Drainage in Contemporary Surgical Treatment of Pancreatic Necrosis.Digestive diseases and sciences · 2025Review
- Intravascular Ultrasound-Guided Covered Endovascular Reconstruction of the Aortic Bifurcation for Acute Aortic Occlusion Concurrent with Severe Acute Necrotizing Pancreatitis: A Case Report.Vascular specialist international · 2025Article
- Diagnostic and therapeutic management of severe acute pancreatitis. Evidence based medicine (EBM) clinical practice guidelines.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2025Article
- Percutaneous Interventions and Necrosectomy in the Management of Peripancreatic Collections.Seminars in interventional radiology · 2025Review
- CLINICAL, DIAGNOSTIC AND THERAPEUTIC CHARACTERIZATION OF PATIENTS WITH PANCREATIC COLLECTIONS DUE TO ACUTE PANCREATITIS IN A REFERRAL HOSPITAL.Arquivos de gastroenterologia · 2025Article
- Genetic Variability in theInternational journal of molecular sciences · 2024Article
- Does the site, size, and number of necrotic collections affect the outcome of necrotizing pancreatitis? - a prospective analysis.Emergency radiology · 2024Article
- Early versus delayed necrosectomy in pancreatic necrosis: A population-based cohort study on readmission, healthcare utilization, and in-hospital mortality.World journal of methodology · 2024Article
- Article
- Bioinformatics analysis of ERCC family in pan-cancer and ERCC2 in bladder cancer.Frontiers in immunology · 2024Article
- Successful resolution of gastric perforation caused by a severe complication of pancreatic walled-off necrosis: A case report.World journal of clinical cases · 2023Article
- RNA-sequencing approach for exploring the protective mechanisms of dexmedetomidine on pancreatic injury in severe acute pancreatitis.Frontiers in pharmacology · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA series of randomized controlled trials have investigated the efficacy and safety of different timings of interventions and methods of intervention. However, the optimal treatment strategy is not yet clear.
methodsWe searched PubMed, EMBASE, ClinicalTrials.gov and the Cochrane Library until November 30, 2022. A systematic review and Bayesian network meta-analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Trials comparing different treatment strategies for necrotizing pancreatitis were included. This study was registered in the Prospective Register of Systematic Reviews (CRD42022364409) to ensure transparency.
resultsWe analyzed a total of 10 studies involving 570 patients and 8 treatment strategies. Although no statistically significant differences were identified comparing odds ratios, trends were confirmed by the surface under the cumulative ranking (SUCRA) scores. The interventions with a low rate of mortality were delayed surgery (DS), delayed surgical step-up approach (DSU) and delayed endoscopic step-up approach (DEU), while the interventions with a low rate of major complications were DSU, DEU and DS. According to the clustered ranking plot, DSU performed the best overall in reducing mortality and major complications, while DD performed the worst. Analysis of the secondary endpoints confirmed the superiority of DEU and DSU in terms of individual components of major complications (organ failure, pancreatic fistula, bleeding, and visceral organ or enterocutaneous fistula), exocrine insufficiency, endocrine insufficiency and length of stay. Overall, DSU was superior to other interventions.
conclusionDSU was the optimal treatment strategy for necrotizing pancreatitis. Drainage alone should be avoided in clinical practice. Any interventions should be postponed for at least 4 weeks if possible. The step-up approach was preferred.
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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.