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Prophylactic Pancreatic Duct Stenting in Acute Necrotizing Pancreatitis (ERPNEC)

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified January 2013 by University of Oulu.
Recruitment status was:  Recruiting
Copenhagen University Hospital, Hvidovre
Information provided by (Responsible Party):
University of Oulu Identifier:
First received: January 10, 2013
Last updated: January 11, 2013
Last verified: January 2013

Since the majority of patients with necrotizing pancreatitis will experience a leak from the pancreatic duct during their course of disease resulting in intra- and peripancreatic fluid collections, it is reasonable to hypothesize that placement of a ductal stent may prevent some of the late complications and morbidity associated with pancreatic necrosis. This prospective, randomized, controlled multicenter trial investigates the role of early prophylactic ductal stenting in acute necrotizing pancreatitis.

The purpose of the study is to determinate the safety and feasibility of early prophylactic pancreatic duct stenting in necrotizing pancreatitis in reducing complications, length of stay in hospital and in in-tensive care unit compared to the traditional treatment.

Condition Intervention
Acute Necrotizing Pancreatitis Procedure: ERCP and pancreatic stenting

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Prophylactic Pancreatic Duct Stenting in Acute Necrotizing Pancreatitis: a Prospective Randomized Controlled Multicenter Study

Resource links provided by NLM:

Further study details as provided by University of Oulu:

Primary Outcome Measures:
  • The need for percutaneous, endoscopic, laparoscopic, or open surgical drainage and/or debridement after randomization. [ Time Frame: 12 months ]

    The indications for drainage/debridement are:

    1. Infection
    2. Gastro-intestinal or bile duct obstruction
    3. Pain caused by pancreatic or peripancreatic collection(s)
    4. Leakage of pancreatic juice (i.e. ascites or pleural fluid with an amylase content greater than 3 times the serum amylase activity)

Estimated Enrollment: 80
Study Start Date: January 2011
Estimated Study Completion Date: December 2015
Estimated Primary Completion Date: December 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Pancreatic stenting
Pancreatic stenting versus observation
Procedure: ERCP and pancreatic stenting


Ages Eligible for Study:   18 Years to 75 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

In patients with suspected necrotizing pancreatitis a pancreatic protocol 3-phase contrast enhanced (CE) CT shall be performed. Since a very early CT may underestimate the extent of pancreatic necro-sis, it is recommended to wait at least 72 hours after the onset of symptoms before CT is done. The CECT may be repeated if the initial CT shows no necroses and the clinical course continues to indicate a severe case.

MRI may be used instead of CT in case of contraindication to intravenous contrast due to renal failure.

If CECT reveals pancreatic necrosis affecting the head, neck, or body of pancreas and the necrosis is suspected to include the main pancreatic duct an informed consent to participate in the study is ob-tained, after which the patient will be randomized to either a) the control group with traditional treat-ment (i.e. at the discretion of each participating center) or to b) the intervention group with same treatment as in the control group plus ERP and PD-stenting. Patients with isolated necrosis of the tail will not be included in the study.

Exclusion Criteria:

All consecutive patients (age between 18-75 years) admitted to the participating centers for acute pan-creatitis with an area of non-enhancing pancreatic parenchyma on CT believed to represent necrosis are prospectively enrolled in the study. At initial presentation the age, gender, etiology of the pancreatitis, clinical and laboratory findings will be recorded. Patients with malignancies and patients from whom an informed consent to participate in the study cannot be obtained will be excluded.

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01767233

Contact: Heikki K Karjula, MD + 358 08 3152830
Contact: Arto O Saarela, PhD + 358 08 3152809

Oulu University Hospital Recruiting
Oulu, Finland, 90029
Contact: Jyrki Mäkelä, Professor    + 358 08 3152011   
Sponsors and Collaborators
University of Oulu
Copenhagen University Hospital, Hvidovre
  More Information

Responsible Party: University of Oulu Identifier: NCT01767233     History of Changes
Other Study ID Numbers: 36/2010
Study First Received: January 10, 2013
Last Updated: January 11, 2013

Keywords provided by University of Oulu:
Acute necrotizing pancreatitis
Pancreatic stenting

Additional relevant MeSH terms:
Pancreatitis, Acute Necrotizing
Pancreatic Diseases
Digestive System Diseases processed this record on September 19, 2017