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Figure 2 | BMC Surgery

Figure 2

From: Minimally invasive 'step-up approach' versus maximal necrosectomy in patients with acute necrotising pancreatitis (PANTER trial): design and rationale of a randomised controlled multicenter trial [ISRCTN13975868]

Figure 2

PANTER flowchart. ® = randomisation. #In the intensive care: within 72 hours, improved function of at least two organ systems (renal/respiratory/cardiovascular) or in the ward: within 72 hours, improvement of two of these three parameters: leucocytes/temperature/CRP. The worst parameter is used. §No clinical improvement within 72 hours after drainage is considered failure: repeat the CT-scan once to check position of the drains. If the position is adequate, and no additional drainable collections are seen, proceed to surgery, if drain position is inadequate: repeat CT-guided percutaneous drainage (or endoscopic transgastric drainage). If after the second drainage there is no clinical improvement within 72 hours, proceed to surgery. If repeat-drainage is not possible, patients proceed to surgery.

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