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@ARTICLE{Vornhlz:305536,
author = {M. Vornhülz and S. Sirtl and Y. Xu and S. Klauss and E.
Orgler-Gasche and M. Bezmarevic and M. Jovanovic and C.
Ricci and M. Fernandez Y Viesca and M. Arvanitakis and A.
Hadi and A. P. Prahm and D. Di Mauro and D. A. Ruess$^*$ and
C. Focke and F. Bender and J. Hamm and C. Ammer-Herrmenau
and T. C. Gonçalves and J. C. Gonçalves and L. Calavrezos
and M. Götz and S. Stoerzer and M. Schmelzle and Ł.
Nawacki and C. Condori and M. Seitzinger and J. Seelig and
S. Chooklin and S. Chuklin and S. Rasch and V. Phillip and
S. Pandanaboyana and R. Aljaberi and M. Kuzman and C.
Meinhardt and B. González de la Higuera Carnicer and D.
Ruiz-Clavijo García and B. Eross and P. Hegyi and N.
Kerbazh and T. V. Moga and K. Pawlak and N. Calo and K.
Khalaf and M. Brunner and L. Schulte and A. Kleger and M. L.
Ruiz Rebollo and M. Seidensticker and M. Wildgruber and U.
Mansmann and H. Stubbe and J. Mayerle and G. Beyer},
collaboration = {V. R. DRACULA study group: Laszlo Czako},
title = {{C}ommon {P}ractice of {P}ercutaneous {D}rainage in
{N}ecrotising {P}ancreatitis-{A} {M}ulticentre
{R}etrospective {S}tudy ({DRACULA}).},
journal = {United european gastroenterology journal},
volume = {nn},
issn = {2050-6406},
address = {Hoboken, NJ},
publisher = {Wiley},
reportid = {DKFZ-2025-02210},
pages = {nn},
year = {2025},
note = {epub},
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.},
keywords = {drainage (Other) / flushing (Other) / necrosis (Other) /
pancreatitis (Other)},
cin = {FR01},
ddc = {610},
cid = {I:(DE-He78)FR01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41137746},
doi = {10.1002/ueg2.70133},
url = {https://inrepo02.dkfz.de/record/305536},
}