Journal Article

DKFZ-2025-02210

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Common Practice of Percutaneous Drainage in Necrotising Pancreatitis-A Multicentre Retrospective Study (DRACULA).

Vornhülz, M. ; Sirtl, S. ; Xu, Y. ; Klauss, S. ; Orgler-Gasche, E. ; Bezmarevic, M. ; Jovanovic, M. ; Ricci, C. ; Fernandez Y Viesca, M. ; Arvanitakis, M. ; Hadi, A. ; Prahm, A. P. ; Di Mauro, D. ; Ruess, D. A.DKFZ* ; Focke, C. ; Bender, F. ; Hamm, J. ; Ammer-Herrmenau, C. ; Gonçalves, T. C. ; Gonçalves, J. C. ; Calavrezos, L. ; Götz, M. ; Stoerzer, S. ; Schmelzle, M. ; Nawacki, Ł. ; Condori, C. ; Seitzinger, M. ; Seelig, J. ; Chooklin, S. ; Chuklin, S. ; Rasch, S. ; Phillip, V. ; Pandanaboyana, S. ; Aljaberi, R. ; Kuzman, M. ; Meinhardt, C. ; González de la Higuera Carnicer, B. ; Ruiz-Clavijo García, D. ; Eross, B. ; Hegyi, P. ; Kerbazh, N. ; Moga, T. V. ; Pawlak, K. ; Calo, N. ; Khalaf, K. ; Brunner, M. ; Schulte, L. ; Kleger, A. ; Ruiz Rebollo, M. L. ; Seidensticker, M. ; Wildgruber, M. ; Mansmann, U. ; Stubbe, H. ; Mayerle, J. ; Beyer, G. ; DRACULA study group: Laszlo Czako, V. R. (Collaboration Author)

2025
Wiley Hoboken, NJ

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Please use a persistent id in citations: doi:10.1002/ueg2.70133

Abstract: Acute necrotising pancreatitis carries high mortality, especially if infected necrosis occurs. While percutaneous drainage may be required when internal drainage is not feasible, reliable guidelines for managing percutaneous drains are lacking. This study aimed to assess the common practice of percutaneous drainage therapy for infected pancreatic necrosis.This retrospective study among 29 tertiary care centres included all patients hospitalised for necrotising acute pancreatitis from 01/2016 until 12/2022 with at least one percutaneous drain. The length of hospital stay was the primary endpoint, with mortality as the secondary endpoint. Between-group comparisons were conducted using the ratio of restricted mean survival time (RMST) after adjusting for confounders.585 patients (67% male) from 29 tertiary care centres in 15 countries in Europe, Canada and Bolivia were included in the analysis. Length of hospitalisation or mortality did not differ between the flushed (n = 398) and non-flushed groups (RMST ratio 1.04, p-value = 0.42 and RMST ratio 1.05, p-value = 0.1 respectively). Mortality was significantly lower in those patients who received a combination of percutaneous and internal drains (dual-modality drainage, n = 243) as compared to those who received percutaneous drains only (RMST ratio 1.05, p-value = 0.01). Flushing with antibiotics as compared to saline was not associated with shorter length of hospital stay or lower mortality (RMST ratio 0.98, p-value = 0.78 and 0.97, p-value = 0.48 respectively).This study reveals notable differences in therapeutic concepts and flushing management for percutaneous drains. While flushing itself was not associated with a shorter length of hospitalisation or lower in-hospital mortality, a lower mortality was observed when internal and percutaneous drainage were used in combination.The study was prospectively registered in the German Clinical Trials Register (Deutsches Register Klinischer Studien, DRKS) under the registration number DRKS00032231.

Keyword(s): drainage ; flushing ; necrosis ; pancreatitis

Note: epub

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Contributing Institute(s):

1. DKTK Koordinierungsstelle Freiburg (FR01)

Research Program(s):

1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2025

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Database coverage:
; Clarivate Analytics Master Journal List ; DEAL Wiley ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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