Trial reportAnnals of surgery2024
Long-Term Outcome of Immediate Versus Postponed Intervention in Patients With Infected Necrotizing Pancreatitis (POINTER): Multicenter Randomized Trial.
Trial report in Annals of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
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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, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- 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
- Understanding the composite failure rate of the step-up approach in infected necrotizing pancreatitis: a scoping review.Updates in surgery · 2026Review
- 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
- Endoscopic drainage in necrotizing pancreatitis: Is the four-week cut-off still relevant?Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025Article
- Revisiting the timing of intervention in necrotising pancreatitis.Intensive care medicine · 2025Article
- Application and Value of Percutaneous Catheter Drainage in Contemporary Surgical Treatment of Pancreatic Necrosis.Digestive diseases and sciences · 2025Review
- Venous Thromboembolism in Unusual Locations.The Medical clinics of North America · 2025Review
- Acute Necrotizing Pancreatitis-Advances and Challenges in Management for Optimal Clinical Outcomes.Medicina (Kaunas, Lithuania) · 2025Review
- Article
- Endoscopic management of infected necrotizing pancreatitis: Advancing through standardization.World journal of gastroenterology · 2025Review
- Approach to the Diagnosis and Management of Infected Pancreatic Necrosis: A Narrative Review.Cureus · 2025Review
- Cost-effectiveness of immediate versus postponed intervention for infected necrotizing pancreatitis: planned secondary analysis of the POINTER trial.The British journal of surgery · 2025Article
- Comment on "Long-Term Outcome of Immediate Versus Postponed Intervention in Patients With Infected Necrotizing Pancreatitis (POINTER)": Multicenter Randomized Trial.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Practical approach to acute pancreatitis: from diagnosis to the management of complications.Internal and emergency medicine · 2024Review
- When to Intervene in Acute Necrotizing Pancreatitis: A Narrative Review of the Optimal Timing for Intervention Strategies.Medicina (Kaunas, Lithuania) · 2024Review
- 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
- Optimal timing of intervention in pancreatic necrosis-current status.Gland surgery · 2024Article
Corrections and comments
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Authors and funding
38 authors at 14 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the long-term outcomes of immediate drainage versus the postponed-drainage approach in patients with infected necrotizing pancreatitis.
backgroundIn the randomized POINTER trial, patients assigned to the postponed-drainage approach using antibiotic treatment required fewer interventions, as compared with immediate drainage, and over a third were treated without any intervention.
methodsClinical data of those patients alive after the initial 6-month follow-up were re-evaluated. The primary outcome was a composite of death and major complications.
resultsOut of 104 patients, 88 were re-evaluated with a median follow-up of 51 months. After the initial 6-month follow-up, the primary outcome occurred in 7 of 47 patients (15%) in the immediate-drainage group and 7 of 41 patients (17%) in the postponed-drainage group (RR 0.87, 95% CI 0.33-2.28; P =0.78). Additional drainage procedures were performed in 7 patients (15%) versus 3 patients (7%) (RR 2.03; 95% CI 0.56-7.37; P =0.34). The median number of additional interventions was 0 (IQR 0-0) in both groups ( P =0.028). In the total follow-up, the median number of interventions was higher in the immediate-drainage group than in the postponed-drainage group (4 vs. 1, P =0.001). Eventually, 14 of 15 patients (93%) in the postponed-drainage group who were successfully treated in the initial 6-month follow-up with antibiotics and without any intervention remained without intervention. At the end of follow-up, pancreatic function and quality of life were similar.
conclusionsAlso, during long-term follow-up, a postponed-drainage approach using antibiotics in patients with infected necrotizing pancreatitis results in fewer interventions as compared with immediate drainage and should therefore be the preferred approach.
trial registrationISRCTN33682933.
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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.