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RECRUITING
NCT05252897
NA

Timing of Necrosectomy After Endoscopic Drainage of Walled-off Pancreatic Necrosis (WON)

Sponsor: Chinese University of Hong Kong

View on ClinicalTrials.gov

Summary

Walled-off pancreatic necrosis (WON) is associated with a mortality of 20-30%. The current evidence supports a minimally invasive drainage approach to infected WON. The current suggested approach in international guidelines is the endoscopic step-up approach. However, recent evidence from large national cohorts support the use of direct endoscopic necrosectomy (DEN) at the time of stent placement, resulting in earlier resolution of WON and less number of necrosectomies. This study aims to investigate the clinical outcomes of the DEN versus the step-up approach for necrosectomy after endoscopic drainage of WON.

Official title: Direct Endoscopic Necrosectomy Versus Endoscopic Step-up Approach After Endoscopic Drainage of Walled-off Pancreatic Necrosis (WON)

Key Details

Gender

All

Age Range

18 Years - Any

Study Type

INTERVENTIONAL

Enrollment

108

Start Date

2022-02-01

Completion Date

2026-06-30

Last Updated

2022-03-09

Healthy Volunteers

No

Interventions

PROCEDURE

Endoscopic necrosectomy with step up approach

Endoscopic necrosectomy will be performed with a forward-viewing gastroscope into the WON cavity. Debridement of necrotic tissue will be performed with irrigation and/or mechanical removal with endoscopic instruments. For this arm, step up approach will be adopted.

PROCEDURE

Endoscopic necrosectomy with direct approach

Endoscopic necrosectomy will be performed with a forward-viewing gastroscope into the WON cavity. Debridement of necrotic tissue will be performed with irrigation and/or mechanical removal with endoscopic instruments. For this arm, the direct approach will be adopted.

Locations (9)

Royal Adelaide Hospital

Adelaide, Australia

The Chinese University of Hong Kong

Hong Kong, Hong Kong

Medanta Institute Of Digestive & Hepatobiliary Sciences

Haryāna, India

Asian Institute of Gastroenterology

Hyderabad, India

Deenanath Mangeshkar Hospital & Research Centre

Pune, India

Asan Medical Centre

Asan, South Korea

SoonChunHyang University School of Medicine

Asan, South Korea

Hospital Universitario Rio Hortega

Valladolid, Spain

King Chulalongkorn Memorial Hospital

Bangkok, Thailand