Effectiveness and Safety of Single-session Endoscopic Stone Extraction
Effectiveness and Safety of Single-session Endoscopic Stone Extraction for Acute Cholangitis Associated With Choledocholithiasis
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Acute cholangitis is an acute inflammation caused by obstruction of the bile duct, of which choledocholithiasis is the most common cause. Without timely removal of the obstruction or control of the infection, cholangitis can get worse and even become life-threatening. Therefore, timely and effective treatment is essential for patients with acute cholangitis combined with choledocholithiasis. Endoscopic retrograde cholangiography (ERCP) is used as the first-line treatment for choledocholithiasis-associated acute cholangitis. Previous guidelines recommended two-session endoscopic therapy. Endoscopic biliary drainage as the initial treatment, followed by endoscopic stone extraction after cholangitis improved. In recent years, studies have found that single-session endoscopic stone extraction is safe and effective for patients without serious organ function impairment. Meanwhile, single-session endoscopic lithotomy can avoid the second ERCP intervention, which can relieve the pain of patients, reduce medical costs and shorten the length of hospital stay. However, there is still insufficient evidence on the effectiveness and safety of early single-session ERCP lithotomy. The aim of this study is to evaluate the efficacy and safety of single-session endoscopic stone extraction for acute cholangitis associated with choledocholithiasis, so as to provide reference of clinical treatment.
In a prospective study, approximately 64 patients with acute cholangitis accompanied with choledocholithiasis will be involved. The investigators assessed the outcomes of single-session and two-session endoscopic stone extraction.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Wei Jiang, Ph.D
- Phone Number: 18663186116
- Email: jfw899w@outlook.com
Study Locations
-
-
Beijing
-
Beijing, Beijing, China, 100050
- Beijing Friendship Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 1. Age ≥18 years old and ≤90 years old
- 2. Patients met the Tokyo Guidelines 2018 (TG18) diagnosis of Grade I or Grade II acute cholangitis
- 3. Imaging examination confirmed the presence of choledocholithiasis
Exclusion Criteria:
- 1. Common bile duct with benign or malignant stenosis
- 2. Changes in the anatomical structure of the stomach or duodenum
- 3. Patients with common biliary duct or pancreatic duct stent
- 4. Patients complicated with acute pancreatitis
- 5. Patients who underwent endoscopic intervention, percutaneous transhepatic cholangio drainage (PTCD) or other invasive interventions before admission
- 6. Patients with cardiac failure, respiratory failure or consciousness disorder can not tolerate endoscopic operation
- 7. Patients who have coagulation dysfunction or are taking anticoagulation and antiplate drugs
- 8. Imaging examination showed that the maximum diameter of choledocholithiasis was more than 1.5cm
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: single-session treatment group
single-session ERCP
|
directly endoscopic stone extraction
|
|
Experimental: two-session treatment group
two-session ERCP
|
early endoscopic drainage followed by endoscopic stone extraction
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Success rate of complete stone removal
Time Frame: during the operation
|
Segmental angiography was performed by balloon closure to determine the presence or absence of negative stone shadow
|
during the operation
|
|
ERCP-related complication rate
Time Frame: from the operation to 1 month after the operation
|
The complications include pancreatitis, hemorrhage, perforation, pneumonia, etc.
The results of intraoperative endoscopic observation, postoperative symptoms and signs, blood routine examination, amylase, lipase, and imaging and endoscopic examination were measured.
|
from the operation to 1 month after the operation
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Length of stay
Time Frame: perioperatively
|
Total time from admission to discharge.
|
perioperatively
|
|
Hospital expenses
Time Frame: perioperatively
|
Total expenses from admission to discharge.
|
perioperatively
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Fujing Lv, M.D., Beijing Friendship Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- BFHHZS20240064
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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