Evidence map›Paper›PMID 40968743›Full record

SynthesisInternational journal of surgery (London, England)2026

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.

Jindan Gao, Zhengquan Wang, Wei Wei, Ruiqin He, Jun Zhang, Defeng Zhang, Jingjing Huang, Xun Wang, Rongrong Yuan, Rong Cai and 5 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of surgery (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

15 authors.

Jindan GaoDepartment of Emergency Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, China.
Zhengquan WangDepartment of Emergency Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, China.
Wei WeiDepartment of Emergency Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, China.
Ruiqin HeDepartment of Emergency Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, China.
Jun ZhangDepartment of Emergency Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, China.
Defeng ZhangDepartment of Emergency Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, China.
Jingjing HuangDepartment of Emergency Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, China.
Xun WangDepartment of Emergency Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, China.
Rongrong YuanDepartment of Emergency Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, China.
Rong CaiDepartment of Emergency Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, China.
Guofeng ChenDepartment of Emergency Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, China.
Zilong LiDepartment of Emergency Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, China.
Lu KeDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
Wen LuDepartment of Emergency Medicine, The Affiliated Yangming Hospital of Ningbo University, Yuyao, Zhejiang, China.
Lin GaoDepartment of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.ORCID 0000-0002-7016-4612

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEvidence regarding the optimal timing of intervention for symptomatic acute necrotic collections (ANCs) in necrotizing pancreatitis remains inconsistent, particularly in the era of minimally invasive step-up approaches. This systematic review and meta-analysis (SR&MA) aimed to compare patient-centered clinical outcomes between early and delayed interventions.

methodsWe searched five databases up to 31 January 2025, for clinical studies involving adult patients with ANCs comparing early minimally invasive interventions with delayed interventions. The primary outcome was overall mortality. Subgroup analyses were also performed.

resultsThis SR&MA included 18 studies [2 randomized controlled trials (RCTs) and 16 observational studies] comprising 2392 patients with symptomatic ANCs requiring intervention. Pooled results demonstrated that early intervention was associated with increased overall mortality [odds ratio (OR) 1.73, 95% confidence interval (CI) 1.34-2.22, P < 0.001, I2 = 4%; 18 studies] and a greater need for open surgery (OR 1.77, 95% CI 1.23-2.56, P = 0.002, I2 = 39%; 11 studies) compared to delayed intervention. However, most studies were assessed to have a high risk of bias. No subgroup differences were found for the primary outcome.

conclusionEarly intervention for symptomatic ANCs was associated with higher overall mortality. Although limited by study quality, these findings suggest early intervention is a potential risk factor for adverse outcomes, warranting cautious clinical consideration.

Indexed as

Minimally Invasive Surgical ProceduresPancreatitis, Acute NecrotizingTime-to-TreatmentHumansTime FactorsTreatment Outcomeacute necrotic collectionsclinical outcomesdelayed interventionearly interventionmeta-analysis

Identifiers

PMID40968743
PMCPMC12825887

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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.