78 | wetenschapsdag 2023 Sessie 2d: Laparos: het Ontwerp Binnenste Binnen Keren x2 Auteurs M.F.G. Francken, D.S. Umans, D. Boerma, L.M.J.W. van Driel, R.C. Verdonk, S.A.W. Bouwense, M.W.J. Stommel, H.C. van Santvoort, R.P. Voermans, M.G.W. Dijkgraaf, J.E. van Hooft, M.G. Besselink for the Dutch Pancreatitis Study Group Abstract titel Preventing recurrent ‘idiopathic’ acute pancreatitis through laparoscopic cholecystectomy (PICUS-2): a multicenter randomized trial’: Dutch Pancreatitis Study Group Background Acute pancreatitis is diagnosed in 6,500 patients yearly in the Netherlands. In up to 25% of patients no definitive cause can be determined after routine work-up including endoscopic ultrasound and this is deemed to be idiopathic acute pancreatitis (IAP) and has a high recurrence rate. It is hypothesized that microlithiasis/ sludge, a type of biliary pancreatitis, is the most common cause of IAP. Laparoscopic cholecystectomy (LC) is highly effective in preventing recurrence of biliary pancreatitis. Currently no randomized trial has compared LC with conservative treatment in patients with IAP after adequate work-up including endoscopic ultrasound. Methods Multicenter randomized controlled trial in 42 centers in the Netherlands and 4 centers in Norway, Sweden, Germany and Italy including adult patients with a first episode of ‘EUSnegative’ IAP. Patients will be randomized (1:1) to receive either LC or conservative treatment. Patients will be followed for one year after randomization. The primary endpoint is recurrent acute pancreatitis. Secondary endpoints include biliary events, complications of LC, number and severity of recurrent episodes of pancreatitis, quality of life (QALY), costs (hospital and societal) and cost-effectiveness. Results Overall, 262 patients will be randomized in 46 centers during a period of 2-3 years. Conclusion PICUS-2 is a multicenter randomized trial which will assess the effectiveness of LC as compared to conservative treatment in patients after a first episode of ‘EUS-negative’ IAP. Our trial will provide evidence whether LC is an effective treatment for IAP.
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