Comparison of Feasibility Between Internal and External Pancreatic Drainage in Pancreaticoduodenectomy

NCT ID: NCT01023594

Last Updated: 2015-09-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

328 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-01-31

Study Completion Date

2016-01-31

Brief Summary

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Pancreatic fistula is one of the most serious complication after pancreatoduodenectomy. To reduce pancreatic fistula, many authors recommend pancreatic stent in pancreatojejunostomy. There are two distinct methods of pancreatic stent insertion: internal stent and external stent. There was few studies comparing these methods in preventing pancreatic fistula. Furthermore, its long-term effect was not known enough. The purpose of this study is to determine which is the best method in preventing pancreatic fistula and to investigate its long term clinical outcomes.

Detailed Description

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Conditions

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Pancreatic Fistula

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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External stent

Feeding tube insert at pancreatojejunostomy site as a stent. And stent tube is brought out through jejunal loop below the hepaticojejunostomy site and abdominal wall.

Group Type ACTIVE_COMPARATOR

Pancreatic stent

Intervention Type PROCEDURE

Feeding tube insert at pancreatojejunostomy site as a stent. And then 1) tube is brought out through jejunal loop below the hepaticojejunostomy site and abdominal wall(external stent)or 2) tube is cut short (5cm length) and left in situ with fixating suture. In external stent group, tube will be removed about 1 months after operation.

Internal stent

short(5cm)internal stent insertion at pancreatojejunostomy site

Group Type ACTIVE_COMPARATOR

Pancreatic stent

Intervention Type PROCEDURE

Feeding tube insert at pancreatojejunostomy site as a stent. And then 1) tube is brought out through jejunal loop below the hepaticojejunostomy site and abdominal wall(external stent)or 2) tube is cut short (5cm length) and left in situ with fixating suture. In external stent group, tube will be removed about 1 months after operation.

Interventions

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Pancreatic stent

Feeding tube insert at pancreatojejunostomy site as a stent. And then 1) tube is brought out through jejunal loop below the hepaticojejunostomy site and abdominal wall(external stent)or 2) tube is cut short (5cm length) and left in situ with fixating suture. In external stent group, tube will be removed about 1 months after operation.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* patient who have malignant or benign disease which needs pancreatoduodenectomy
* patient age: ≥20 and ≤85

Exclusion Criteria

* patient who had chemotherapy or radiotherapy previous to operation.
* patient who had severe comorbid disease(cardiac, pulmonary, cerebrovascular)
* patient who had past medical history of chronic pancreatitis.
* pancreatic stent size \<1mm or \>5mm
Minimum Eligible Age

20 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Seoul National University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Sun-Whe Kim

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sun-Whe Kim, M.D.

Role: STUDY_CHAIR

Seoul National University Hospital

Locations

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Center for Liver Cancer, National Cancer Center

Goyang-si, Gyeonggi-do, South Korea

Site Status

Department of Surgery, Seoul National University Bundang Hospital

Seongnam-si, Gyeonggi-do, South Korea

Site Status

Department of Surgery, Seoul National University Hospital

Seoul, Seoul, South Korea

Site Status

Department of Surgery, Samsung Medical Center

Seoul, , South Korea

Site Status

Department of Surgery, Korea University Guro Hospital

Seoul, , South Korea

Site Status

Department of Surgery, Seoul National University Boramae Hospital

Seoul, , South Korea

Site Status

Department of Surgery, Chung-ang University College of Medicine

Seoul, , South Korea

Site Status

Department of Surgery, Gangnam Severance Hospital

Seoul, , South Korea

Site Status

Countries

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South Korea

References

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Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, Neoptolemos J, Sarr M, Traverso W, Buchler M; International Study Group on Pancreatic Fistula Definition. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005 Jul;138(1):8-13. doi: 10.1016/j.surg.2005.05.001.

Reference Type BACKGROUND
PMID: 16003309 (View on PubMed)

Lowy AM, Lee JE, Pisters PW, Davidson BS, Fenoglio CJ, Stanford P, Jinnah R, Evans DB. Prospective, randomized trial of octreotide to prevent pancreatic fistula after pancreaticoduodenectomy for malignant disease. Ann Surg. 1997 Nov;226(5):632-41. doi: 10.1097/00000658-199711000-00008.

Reference Type BACKGROUND
PMID: 9389397 (View on PubMed)

Butturini G, Daskalaki D, Molinari E, Scopelliti F, Casarotto A, Bassi C. Pancreatic fistula: definition and current problems. J Hepatobiliary Pancreat Surg. 2008;15(3):247-51. doi: 10.1007/s00534-007-1301-y. Epub 2008 Jun 6.

Reference Type BACKGROUND
PMID: 18535760 (View on PubMed)

Poon RT, Fan ST, Lo CM, Ng KK, Yuen WK, Yeung C, Wong J. External drainage of pancreatic duct with a stent to reduce leakage rate of pancreaticojejunostomy after pancreaticoduodenectomy: a prospective randomized trial. Ann Surg. 2007 Sep;246(3):425-33; discussion 433-5. doi: 10.1097/SLA.0b013e3181492c28.

Reference Type BACKGROUND
PMID: 17717446 (View on PubMed)

Roder JD, Stein HJ, Bottcher KA, Busch R, Heidecke CD, Siewert JR. Stented versus nonstented pancreaticojejunostomy after pancreatoduodenectomy: a prospective study. Ann Surg. 1999 Jan;229(1):41-8. doi: 10.1097/00000658-199901000-00005.

Reference Type BACKGROUND
PMID: 9923798 (View on PubMed)

Kamoda Y, Fujino Y, Matsumoto I, Shinzeki M, Sakai T, Kuroda Y. Usefulness of performing a pancreaticojejunostomy with an internal stent after a pancreatoduodenectomy. Surg Today. 2008;38(6):524-8. doi: 10.1007/s00595-007-3662-x. Epub 2008 May 31.

Reference Type BACKGROUND
PMID: 18516532 (View on PubMed)

Ohwada S, Tanahashi Y, Ogawa T, Kawate S, Hamada K, Tago KI, Yamada T, Morishita Y. In situ vs ex situ pancreatic duct stents of duct-to-mucosa pancreaticojejunostomy after pancreaticoduodenectomy with billroth I-type reconstruction. Arch Surg. 2002 Nov;137(11):1289-93. doi: 10.1001/archsurg.137.11.1289.

Reference Type BACKGROUND
PMID: 12413321 (View on PubMed)

Imaizumi T, Hatori T, Tobita K, Fukuda A, Takasaki K, Makuuchi H. Pancreaticojejunostomy using duct-to-mucosa anastomosis without a stenting tube. J Hepatobiliary Pancreat Surg. 2006;13(3):194-201. doi: 10.1007/s00534-005-1037-5.

Reference Type BACKGROUND
PMID: 16708294 (View on PubMed)

Kim SW, Youk EG, Park YH. Comparison of pancreatogastrostomy and pancreatojejunostomy after pancreatoduodenectomy performed by one surgeon. World J Surg. 1997 Jul-Aug;21(6):640-3. doi: 10.1007/s002689900286.

Reference Type BACKGROUND
PMID: 9230663 (View on PubMed)

Winter JM, Cameron JL, Campbell KA, Chang DC, Riall TS, Schulick RD, Choti MA, Coleman J, Hodgin MB, Sauter PK, Sonnenday CJ, Wolfgang CL, Marohn MR, Yeo CJ. Does pancreatic duct stenting decrease the rate of pancreatic fistula following pancreaticoduodenectomy? Results of a prospective randomized trial. J Gastrointest Surg. 2006 Nov;10(9):1280-90; discussion 1290. doi: 10.1016/j.gassur.2006.07.020.

Reference Type BACKGROUND
PMID: 17114014 (View on PubMed)

Jang JY, Chang YR, Kim SW, Choi SH, Park SJ, Lee SE, Lim CS, Kang MJ, Lee H, Heo JS. Randomized multicentre trial comparing external and internal pancreatic stenting during pancreaticoduodenectomy. Br J Surg. 2016 May;103(6):668-675. doi: 10.1002/bjs.10160. Epub 2016 Apr 4.

Reference Type DERIVED
PMID: 27040594 (View on PubMed)

Other Identifiers

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H-0908-040-290

Identifier Type: -

Identifier Source: org_study_id

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