- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02394327
Endoscopic Nasogallbladder Drainage Versus Gallbladder Stenting Before Cholecystecomy
Endoscopic Naso-gallbladder Drainage Versus Gallbladder Stenting Before Elective Cholecystectomy in Patients With Acute Cholecystitis and a High Suspicion of Common Bile Duct Stone; A Prospective Randomized Preliminary Study
Early laparoscopic cholecystectomy is the current standard therapy for acute cholecystitis, but temporary decompression of the gallbladder (GB) through percutaneous or endoscopic route can be required to alleviate inflammatory process and reach an appropriate time for elective surgery in patients with high operative risk or marked local inflammation or organ dysfunction. Also preoperative endoscopic retrograde cholangiopancreatography (ERCP) is often needed because common bile duct (CBD) stone is accompanied in patients with acute cholecystitis at reported rate from 7-20%.
Two-steps approach of percutaneous transhepatic GB drainage (PTGBD) followed by ERCP or vice versa has been performed for the treatment of acute cholecystitis with concomitant CBD stone who are not suitable for urgent cholecystectomy. However single-step drainage of CBD and GB through ERCP and endoscopic transpapillary GB drainage (ETGD) using nasocystic tube or plastic stent has alternatively been attempted in patients who have contraindications for PTGBD. In clinical practice, many endoscopists have hesitated to perform ETGD because of its relatively low technical success rate and specific concern about post-ERCP adverse event but it minimizes catheter keeping duration, and provides effective clinical improvement via physiologic route.
Currently there are scarce data on if ETGD using nasocystic tube or plastic stent are comparable in terms of clinical efficacy and safety.
Study Overview
Status
Conditions
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Gyeonggido
-
Suwon, Gyeonggido, Korea, Republic of, 443-380
- Ajou University Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- grade II or III acute cholecystitis met Tokyo 13 diagnostic criteria
- a high suspicion of CBD stone based on laboratory and imaging study
- informed consent given.
Exclusion Criteria:
- bilo-pancreatic malignancy or surgically altered enteric anatomy
- subsequent elective surgery is expected to be impossible even after GB decompression based on American Society of Anesthesiologist class
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Endoscopic nasogallbladder drainage
If GB cannulation was achieved and the wire was coiled in the GB, 5 to 7-Fr Pigtail type naso-cholecystic drainage tube (Liguory nasal biliary drainage set; Wilson-Cook Medical, Salem, NC, USA) was placed into the GB
|
Endoscopic
|
Active Comparator: Endoscopic gallbladder stenting
If GB cannulation was achieved and the wire was coiled in the GB, 7-Fr double pigtail plastic stent (Zimmon; Wilson-Cook Medical, Salem, NC, USA) was placed into the GB
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Techncal success rate
Time Frame: From the time of randomization until the time when the endoscopic procedure is ended, assessed up to 24hours
|
This outcome was defined as successful deep GB cannulation and placement of assigned drainage device by randomization, and determined by the operator based on the fluoroscoic images of the procedures.
|
From the time of randomization until the time when the endoscopic procedure is ended, assessed up to 24hours
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Clinical success rate
Time Frame: From the date of randomization until the date of clinical improvement (fever, leukocytosis, abdominal pain), assessed up to 72 hours
|
This outcome was defined as improvement of three clinical parameters of acute cholecystitis (fever, abdominal pain, leukocytosis) within 72 hours following either type of ETGD procedure, and assessed by the review of patient's mediacal records.
|
From the date of randomization until the date of clinical improvement (fever, leukocytosis, abdominal pain), assessed up to 72 hours
|
early adverse event
Time Frame: From the date of the randomization until the date of the elective cholecystectomy, assessed up to 2 weeks
|
This outcome was defined as any procedure related event occurring between the endoscopic procedure and elective cholecystectomy, and assessed by the patient's medical records.
|
From the date of the randomization until the date of the elective cholecystectomy, assessed up to 2 weeks
|
Collaborators and Investigators
Investigators
- Study Director: Byung Moo Yoo, MD, Ajou University School of Medicine
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- AJIRB-MED-MDB-11-318
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Cholecystitis, Acute
-
Azienda Ospedaliero, Universitaria PisanaCompletedAcute CholecystitisItaly
-
University Hospital, GhentCompletedUncomplicated Acute CholecystitisBelgium, Qatar
-
Konya Meram State HospitalCompleted
-
The University of Texas Health Science Center at...CompletedAcute Cholecystitis | Chronic CholecystitisUnited States
-
Ain Shams UniversityCompletedCholecystitis | Chronic Calculous Cholecystitis | Acute Calculous CholecystitisEgypt
-
IRCCS Policlinico S. MatteoCompleted
-
Hospital del MarCompletedAcute Cholecystitis
-
South Valley UniversityCompletedAcute CholecystitisEgypt
-
Asklepios Klinik LangenUniversity Hospital FrankfurtCompletedAcute Cholecystitis
-
Istituto Clinico Humanitas Mater DominiRecruiting