Article Dans Une Revue Intensive Care Medicine Année : 2025

Early versus delayed catheter drainage for patients with necrotizing pancreatitis and early persistent organ failure (TIMING): a multicenter randomized controlled trial

Lu Ke
  • Fonction : Auteur
Gang Li
  • Fonction : Auteur
Wenjian Mao
  • Fonction : Auteur
Gordon Doig
  • Fonction : Auteur
Tao Chen
  • Fonction : Auteur
Chao Li
  • Fonction : Auteur
Cheng Qu
  • Fonction : Auteur
Lanting Wang
  • Fonction : Auteur
Lin Gao
  • Fonction : Auteur
Wenhua He
  • Fonction : Auteur
Liang Xia
  • Fonction : Auteur
Feng Guo
  • Fonction : Auteur
Yongjun Lin
  • Fonction : Auteur
Quanxin Feng
  • Fonction : Auteur
Zhiyong Liu
  • Fonction : Auteur
Baiqiang Li
  • Fonction : Auteur
Georgios Papachristou
  • Fonction : Auteur
Yin Zhu
  • Fonction : Auteur
Yuxiu Liu
  • Fonction : Auteur
John Windsor
  • Fonction : Auteur
Zhihui Tong
  • Fonction : Auteur
Weiqin Li

Résumé

Purpose: Acute necrotic collection (ANC) is an early, local complication of necrotizing pancreatitis, and guidelines recommend a deliberate delay in treating ANC. In patients with early persistent organ failure, such delay may be harmful. This study aimed to assess whether early intervention for ANC confers clinical benefits in this patient population. Methods: This is a multicenter, open-label, randomized controlled trial. At 7 days after disease onset, patients with ANC and persistent organ failure were screened for: (1) organ failure lasting longer than 7 days; (2) organ failure worsening in severity; or (3) new-onset organ failure. If one or more criteria were met, they were randomized to receive either early percutaneous catheter drainage or standard care. The primary outcome was a composite of major complications and/or death during the index admission. Results: Overall, 120 patients were randomized to early intervention (N = 63) or standard care (N = 57). There was no difference in the primary composite outcome (33.3% [21/63] versus 36.8% [21/57]; risk difference [RD] - 3.5%; 95% CI, - 20.6 to 13.6%) or the individual components, including mortality. The study groups did not differ in terms of organ failure free days to 21 days after randomization (4 days [interquartile range 0-14] versus 1 day [interquartile range 0-15]). The requirement for minimally invasive debridement and open surgery was comparable between groups. Conclusion: Early catheter drainage for ANCs in patients with necrotizing pancreatitis and early persistent organ failure, compared with standard delayed care, did not improve clinical outcomes. Future larger trials are needed to confirm our findings.

Fichier principal
Vignette du fichier
2025 Ke et al., Early versus.pdf (565.05 Ko) Télécharger le fichier
Origine Fichiers produits par l'(les) auteur(s)
Licence

Dates et versions

hal-05162005 , version 1 (09-02-2026)

Licence

Identifiants

Citer

Lu Ke, Gang Li, Wenjian Mao, Gordon Doig, Tao Chen, et al.. Early versus delayed catheter drainage for patients with necrotizing pancreatitis and early persistent organ failure (TIMING): a multicenter randomized controlled trial. Intensive Care Medicine, 2025, 51 (8), pp.1431-1441. ⟨10.1007/s00134-025-08020-x⟩. ⟨hal-05162005⟩
72 Consultations
70 Téléchargements

Altmetric

Partager

  • More