Early and accurate diagnosis of disconnected Pancreatic duct syndrOme and pancreatic fistuLa in patients with Acute necRotizing pancreatitis

Disrupted or disconnected pancreatic duct syndrome and pancreatic fistula after necrotizing pancreatitis are a clinical dilemma in daily practice. The exact incidence and clinical outcomes are unclear and there is debate on which treatment should follow. The aim of this study is to provide insight in the actual incidence and clinical impact of disrupted or disconnected pancreatic duct syndrome in an unselected cohort of patients with acute necrotizing pancreatitis.

This multicentre prospective observational cohort study will include 98 adult patients with necrotizing pancreatitis. All patients with necrotizing pancreatitis will undergo a predefined, according to the current guidelines, work-up including MRCP. In case of percutaneous drainage, amylase level in drain fluids will be measured routinely. Follow-up will be one year and includes clinical follow-up and patient questionnaires. The primary outcome is incidence of disrupted or disconnected pancreatic duct syndrome and pancreatic fistula. Secondary endpoint is the clinical outcome of patients with and without a disrupted or disconnected pancreatic duct.

This study will lead to early and accurate diagnosis of disrupted or disconnected pancreatic duct syndrome or pancreatic fistula in necrotizing pancreatitis. The obtained data will be used to develop a best-practice algorithm for the diagnosis and, eventually, treatment of disrupted or disconnected pancreatic duct syndrome and pancreatic fistula. This will hopefully lead to a shorter disease course with fewer complications, a faster recovery, lower health care costs and improved quality of life.

Follow-up will be one year and includes clinical follow-up and patient questionnaires, after one year primary and secondary outcomes will be measured.

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