Preventing recurrent idiopathic acute pancreatitis with laparoscopic surgery

Preventing Recurrent 'Idiopathic' Acute Pancreatitis Through Laparoscopic Cholecystectomy (PICUS-2): a Multicenter Randomized Trial

Not applicable Interventional Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) · NCT06391359

This study is testing if laparoscopic surgery to remove the gallbladder can help adults who had a first episode of unexplained acute pancreatitis avoid having it happen again, compared to just managing it with regular treatment.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment262 (estimated)
Ages18 Years and up
SexAll
SponsorAcademisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) Academic / other
Locations1 site (Amsterdam, North Holland)
Trial IDNCT06391359 on ClinicalTrials.gov

What this trial studies

This clinical trial aims to evaluate the effectiveness of laparoscopic cholecystectomy (LC) compared to conservative treatment in adults who have experienced a first episode of 'EUS-negative' idiopathic acute pancreatitis (IAP). The study will involve a multicenter randomized controlled design, where participants will be followed for one year after randomization to assess recurrence rates of pancreatitis. The hypothesis is that microlithiasis may be a common underlying cause of IAP, and that LC could significantly reduce the risk of recurrence. The trial is designed to fill a gap in current knowledge, as no prior randomized trials have compared these two treatment approaches in this patient population.

Who should consider this trial

Good fit: Ideal candidates for this study are adults aged 18 and older who have had a first episode of 'EUS-negative' idiopathic acute pancreatitis and are eligible for laparoscopic cholecystectomy.

Not a fit: Patients with recurrent acute pancreatitis, chronic pancreatitis, or those with a documented etiology of their condition may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide a definitive treatment option to prevent recurrent episodes of idiopathic acute pancreatitis.

How similar studies have performed: While this approach is novel in the context of idiopathic acute pancreatitis, laparoscopic cholecystectomy has shown success in preventing recurrence in biliary pancreatitis, suggesting potential for positive outcomes in this study.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* At least 18 years old
* Eligible for early (laparoscopic)\* cholecystectomy
* Full required diagnostic work-up of patient has been performed, including EUS
* First episode of 'EUS-negative' IAP
* Informed consent for participation was obtained \*if required open cholecystectomy is allowed

Exclusion Criteria:

* Recurrent acute pancreatitis
* Diagnosis of chronic pancreatitis
* Diagnosis of necrotizing pancreatitis
* Current pancreatic malignancy
* Prior cholecystectomy
* Documented etiology of acute pancreatitis

Where this trial is running

Amsterdam, North Holland

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Idiopathic Acute Pancreatitis
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.