REMBRANDT

The REMBRANDT trial addresses a heavy burden for the pancreatic cancer patient population. The only curative treatment option for pancreatic cancer is pancreatic surgery, in the vast majority of cases comprising pancreatic head resection. In this complex surgery, a surgeon removes the pancreatic head, the duodenum and part of the bile duct. After removal, they perform a surgical reconstruction in which three new connections (i.e. ‘anastomoses’) are being made.

This operation is associated with postoperative complications, such as delayed gastric emptying (DGE) and anastomotic leaks (e.g. postoperative pancreatic fistulas (POPF)). DGE is characterized by prolonged requirement of a nasogastric tube, inability to tolerate solid foods, vomiting and gastric distension. It is a burden for patients, impedes their recovery and may hamper the ability to undergo adjuvant chemotherapy.

A possible mean to prevent these complications after pancreatic surgery is by adding an extra anastomosis after reconstruction for pancreatic surgery, the so-called Braun anastomosis.

Working together with the patients association Living with Hope, dr. van Laarhoven and his team aims at evaluating the effectiveness of the addition of the Braun anastomosis after standard Child reconstruction in pancreatic head resection in reducing the incidence of delayed gastric emptying (DGE) and anastomotic leaks (e.g., postoperative pancreatic fistulas (POPF)).

REMBRANDT is a randomized-controlled patient-centered trial testing for superiority of the intervention. It involves 15 centers in the Netherlands, all part of the Dutch Pancreatic Cancer Group (DPCG). It plans to recruit a total of 256 patients, 128 per arm.

The ultimate goal of this study is to ameliorate the procedure of pancreatoduodenectomy with Child reconstruction so to decrease its burdensome postoperative complications.