acute pancreatitis
Conditions
Interventions
Control Group (Delayed Drainage Group):Patients in the control group are managed with a delayed approach, waiting until the peripancreatic fluid sufficiently encapsulates to form a pseudocyst or encap
Experimental Group (Early Drainage Group):For patients meeting the screening criteria, an early drainage strategy is initiated within 24 hours of enrollment.
Sponsors
Shanghai General Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 90 Years
Inclusion criteria
Inclusion criteria: - Onset of illness less than 4 weeks. - Meets the diagnostic criteria for acute pancreatitis: According to the 2012 Atlanta classification and definition revision international consensus, the diagnosis of acute pancreatitis requires 2 of the following 3 features: 1. Abdominal pain characteristic of acute pancreatitis (acute onset of persistent, severe upper abdominal pain often radiating to the back). 2. Serum lipase activity (or amylase activity) at least 3 times greater than the upper limit of normal. 3. Abdominal CT, less commonly used MRI, or abdominal ultrasound showing characteristic changes of acute pancreatitis. - Meets the diagnostic criteria for severe acute pancreatitis: Diagnosis of acute pancreatitis with persistent (>48h) organ dysfunction (single or multiple organs). - Confirmed/highly suspected peripancreatic fluid collection with infection: Abdominal imaging (CT or MRI) suggests peripancreatic fluid with gas formation; endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) indicates positive etiology; clinical exclusion of other infection factors (lung infection, urinary tract infection, catheter-related infection, etc.) and highly suspected pancreatic infective necrosis. Meeting any one of these conditions is sufficient. - Patients with symptoms of abdominal compression due to a large amount of peripancreatic fluid (intra-abdominal hypertension/compartment syndrome), or compression of the inferior vena cava or superior mesenteric vein, or compression of the common bile duct leading to biliary dilation, or patients with persistent organ failure that cannot be relieved. - No gender restriction, age 18 years and above. - Patient or family agrees to participate in this study and signs an informed consent form, agreeing to participate in this research.
Exclusion criteria
Exclusion criteria: - Patients requiring open surgical intervention due to specific clinical situations such as intra-abdominal compartment syndrome, intra-abdominal hemorrhage, visceral perforation, etc., and thus not suitable for endoscopic or percutaneous step-up therapy. - Patients who have participated in another clinical trial within the past 3 months, or have previously undergone surgical treatment for peripancreatic fluid collection. - Patients with a confirmed diagnosis of chronic pancreatitis.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Comprehensive Complication Index (CCI); | — |
Secondary
| Measure | Time frame |
|---|---|
| AP Severity Scores; Biochemical Indicators(Serum bilirubin, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, blood amylase, blood calcium);Number of total interventions;Hospitalization Time, ICU Stay Duration, Hospitalization Costs; | — |
Countries
China
Contacts
Public ContactBaiwen Li
Department of Gastroenterology, Shanghai general hospital
Outcome results
None listed