Long-Term Follow-Up Confirms That Delaying Drainage of Infected Necrotizing Pancreatitis Is Safe

The best timing for intervention in patients with necrotizing pancreatitis has been debated extensively. In a trial published in 2021, Dutch investigators randomized 104 patients with infected necrotizing pancreatitis to either immediate or delayed drainage. All patients received antibiotics. At 6 months, immediate catheter drainage was not superior to postponed drainage, and 39% of patients in the delayed-intervention group never required drainage (NEJM JW Gen Med Nov 15 2021 and N Engl J Med 2021; 385:1372). Now, the researchers have examined longer-term outcomes.

Twelve patients died in the first 6 months of the trial, and 4 additional patients in each group died during prolonged follow-up of 51 months. Two deaths in the immediate-interve…