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CompletedNCT02084537MISERUpdated Feb 11, 2019

Minimally Invasive Surgery vs. Endoscopy Randomized (MISER) Trial for Necrotizing Pancreatitis

An interventional study of Endoscopic treatment and Minimally invasive surgical necrosectomy in Necrosis of Pancreas and Infected Pancreatic Necrosis, sponsored by AdventHealth. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-02-11.

Sponsored by AdventHealth · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
69
Allocation
Randomized
Ages
18 Years and older
Sex
All
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Study summary

Prospective, randomized controlled trial comparing Endoscopic Ultrasound (EUS) Guided cystogastrostomy or cystoduodenostomy and endoscopic necrosectomy to minimally invasive surgical necrosectomy, in patients with necrotizing pancreatitis.

Read the detailed description

Patients will be randomly allocated to either treatment arm in a 1:1 ratio. Following intervention, patients will be assessed at regular intervals until study completion at 6 months post-discharge. Primary outcome is a composite of major complications and/or mortality, measured to 6 months post-discharge.

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Conditions studied

  • Necrosis of Pancreas
  • Infected Pancreatic Necrosis

Keywords

  • symptomatic
  • infected
  • necrotic collection
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In context

Pancreatitis

752 studies on the registry are indexed under Pancreatitis; 181 are open to participants now.

This study's enrollment of 69 is below the median of 80 across 448 interventional studies indexed under Pancreatitis.

Browse Pancreatitis studies →

Lead sponsor

AdventHealth is the lead sponsor of 107 studies on the registry; 25 are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 2 (40%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Necrotic collection

    • Infected (suspected and confirmed): clinical signs of infection (septic, positive cultures, febrile), systemic inflammatory response syndrome, gas within the collection on imaging (not iatrogenic), or positive culture of collection contents
  • Necrotic collection is within 15mm of the lumen of the gastrointestinal tract.
  • 18 years and older
  • Informed consent obtained from the patient or their medical representative.
  • Medically fit for general anesthetic
  • Collection amenable to either endoscopic or minimally invasive surgical necrosectomy and drainage.

Exclusion criteria

Exclusion Criteria:

  • \<18 years old
  • Unable to obtain informed consent from the patient or their medical representative.
  • Medically unfit for general anesthesia
  • Pregnant
  • Necrotic collection not accessible by either or both techniques
  • The collection is >15mm from the lumen of the gastrointestinal tract.
  • Irreversible coagulopathy: International Normalized Ratio (INR) >1.5
  • Irreversible thrombocytopenia: platelet count \<50 x10\^9/L
  • Dual antiplatelet therapy or therapeutic anticoagulation that cannot be withheld for the procedure
  • Surgical or endoscopic necrosectomy or pseudocyst drainage has been performed within the preceding 12 months
  • Necrotic collection secondary to trauma or other surgical event that requires additional interventions such as management of liver lacerations or vascular injury.
  • Pre-existing percutaneous drain
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
69 participants (actual)

Study arms

  • Active comparator
    Endoscopic treatment

    Treated by single or multiple transmural cystogastrostomy tracts, 15mm balloon dilation, two 7 French (Fr) double pigtail plastic stents or lumen-apposing metal stents and nasocystic drainage catheter, with or without endoscopic necrosectomy as needed.

    Procedure: Endoscopic treatment

  • Active comparator
    Minimally invasive surgical necrosectomy

    Video-assisted retroperitoneal debridement (VARD) or laparoscopic approach. This includes laparoscopic cystogastrostomy with internal debridement.

    Procedure: Minimally invasive surgical necrosectomy

Interventions

  • ProcedureEndoscopic treatment

    Treated by single or multiple transmural cystogastrostomy tracts, 15mm balloon dilation, two 7fr double pigtail plastic stents or lumen-apposing metal stents and nasocystic drainage catheter, with or without endoscopic necrosectomy as needed.

    Also known as: Endoscopic cystogastrostomy, Endoscopic cystoduodenostomy, Endoscopic necrosectomy

  • ProcedureMinimally invasive surgical necrosectomy

    Video-assisted retroperitoneal debridement (VARD) or laparoscopic cystogastrostomy with internal debridement.

    Also known as: Video-assisted retroperitoneal debridement (VARD), Laparoscopic cystogastrostomy with internal debridement

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What researchers measure

Primary outcomes

  1. Major complications

    Composite of major complications and/or mortality (all cause and disease specific), measured to 6 months post discharge

    Time frame: 6 months post discharge

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Study locations

1 site
  • Florida Hospital Center for Interventional Endoscopy
    Orlando, Florida 34786, United States
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References and documents

Publications

  • Bang JY, Arnoletti JP, Holt BA, Sutton B, Hasan MK, Navaneethan U, Feranec N, Wilcox CM, Tharian B, Hawes RH, Varadarajulu S. An Endoscopic Transluminal Approach, Compared With Minimally Invasive Surgery, Reduces Complications and Costs for Patients With Necrotizing Pancreatitis. Gastroenterology. 2019 Mar;156(4):1027-1040.e3. doi: 10.1053/j.gastro.2018.11.031. Epub 2018 Nov 16. PubMed 30452918 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 11, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02084537
Lead sponsor
AdventHealth
Responsible party
Sponsor
First posted
Mar 12, 2014
Start date
Apr 2014
Primary completion
Dec 31, 2017
Completion
Sep 30, 2018
Last update
Feb 11, 2019

Study contacts

Shyam S Varadarajulu, MD
principal investigator · AdventHealth

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2019. You cannot join it, but the record below documents what was studied.

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