T-tube drainage versus choledochojejunostomy in hepatolithiasis patients with sphincter of Oddi laxity: study protocol for a randomized controlled trial

Jiang-Ming Chen, Xi-Yang Yan, Tao Zhu, Zi-Xiang Chen, Yi-Jun Zhao, Kun Xie, Fu-Bao Liu, Xiao-Ping Geng, Jiang-Ming Chen, Xi-Yang Yan, Tao Zhu, Zi-Xiang Chen, Yi-Jun Zhao, Kun Xie, Fu-Bao Liu, Xiao-Ping Geng

Abstract

Background: Residual and recurrent stones remain one of the most important challenges of hepatolithiasis and are reported in 20 to 50% of patients treated for this condition. To date, the two most common surgical procedures performed for hepatolithiasis are choledochojejunostomy and T-tube drainage for biliary drainage. The goal of the present study was to evaluate the therapeutic safety and perioperative and long-term outcomes of choledochojejunostomy versus T-tube drainage for hepatolithiasis patients with sphincter of Oddi laxity (SOL).

Methods/design: In total, 210 patients who met the following eligibility criteria were included and were randomized to the choledochojejunostomy arm or T-tube drainage arm in a 1:1 ratio: (1) diagnosed with hepatolithiasis with SOL during surgery; (2) underwent foci removal, stone extraction and stricture correction during the operation; (3) provided written informed consent; (4) was willing to complete a 3-year follow-up; and (5) aged between 18 and 70 years. The primary efficacy endpoint of the trial will be the incidence of biliary complications (stone recurrence, biliary stricture, cholangitis) during the 3 years after surgery. The secondary outcomes will be the surgical, perioperative and long-term follow-up outcomes.

Discussion: This is a prospective, single-centre and randomized controlled two-group parallel trial designed to demonstrate which drainage method (Roux-en-Y hepaticojejunostomy or T-tube drainage) can better reduce biliary complications (stone recurrence, biliary stricture, cholangitis) in hepatolithiasis patients with SOL.

Trial registration: Clinical Trials.gov: NCT04218669 . Registered on 6 January 2020.

Keywords: Choledochojejunostomy; Hepatolithiasis; Sphincter of Oddi; T-tube drainage.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig 1
Fig 1
Flowchart according to CONSORT
Fig 2
Fig 2
Schedule of enrollments, interventions and assessments. Abbreviations: t1, 3 months after surgery; t2, 6 months after surgery; t3, 1 year after surgery; t4, 2 years after surgery; t5, 3 years after surgery
Fig 3
Fig 3
Shape of the sphincter of oddi. a Radial form. b Comma form. c Oval form. d Irregular form

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Source: PubMed

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