Fig. 1.

SPIRIT schedule of enrollment, interventions, and assessments. *In the case of no clinical improvement. ^βBaseline variables: age, sex, center, body mass index, etiology of pancreatitis, American Society of Anesthesiologist’s classification, co-morbidity, disease severity, suspected or proven infected necrosis, time from admission to randomization, time from admission to tertiary referral. ^Primary outcome: Comprehensive Complications Index. ^#Secondary outcomes: mortality, complications, number of (repeat) interventions, hospital and intensive care unit lengths of stay, quality-adjusted life years and direct and indirect costs