Uncovered Self-expandable Metal Stent Versus Double Layer Plastic Stent for Malignant Hilar Stricture

NCT ID: NCT01125865

Last Updated: 2011-03-10

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

PHASE4

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-05-31

Study Completion Date

2011-12-31

Brief Summary

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The overall median survival of nonresectable malignant hilar obstruction in most series has been less than 6 months. Most patients with malignant hilar obstruction present with advanced disease, making palliative endoscopic drainage the principal therapeutic option. However, the optimal endoscopic management strategy is contentious. Almost all of the published data comparing plastic and metallic stents relate to distal tumors (those of the pancreas, common bile duct and ampulla). Stent patency, complication rates, and cost-effectiveness have favored metallic stents when compared with plastic stents in patients with distal malignant obstruction expected to live at least 3 to 6 months.

There are few comparative study as to whether self-expanding metallic or plastic stent, especially DLS (double layer plastic stent) are preferable in the technical success, stent patency, and cost-effectiveness for palliating malignant hilar obstruction.

The study was designed to compare the the technical success, stent patency, and cost-effectiveness of self-expandable metal stent and DLS in patients with malignant hilar obstruction.

Detailed Description

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Conditions

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Bile Duct Obstruction Klatskin's Tumor

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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SEMS

Self-expandable metallic stent will be inserted for the malignant hilar obstruction.

Group Type ACTIVE_COMPARATOR

SEMS insertion

Intervention Type DEVICE

Self-expandable metallic stent will be inserted for malignant hilar obstruction.

DLS

DoubleLayer plastic stent (Olympus) will be inserted for malignant hilar obstruction.

Group Type ACTIVE_COMPARATOR

DLS insertion

Intervention Type DEVICE

DoubleLayer plastic stent will be inserted for malignant hilar obstruction.

Interventions

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SEMS insertion

Self-expandable metallic stent will be inserted for malignant hilar obstruction.

Intervention Type DEVICE

DLS insertion

DoubleLayer plastic stent will be inserted for malignant hilar obstruction.

Intervention Type DEVICE

Other Intervention Names

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Bona stent TaeWoong stent Olympus DoubleLayer stent

Eligibility Criteria

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Inclusion Criteria

* Patient over 18 years old
* Patient with malignant hilar obstruction

Exclusion Criteria

* No written informed consent
* Patient with uncorrectable severe coagulopathy
* Indication for surgical operation
* Karnofsky score \< 60%
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Soon Chun Hyang University

OTHER

Sponsor Role lead

Responsible Party

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Soon Chun Hyang University Cheonan Hospital

Locations

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Soon Chun Hyang University Cheonan Hospital

Cheonan, 23-20 Bongmyung-dong, South Korea

Site Status RECRUITING

Inje University Pusan Paik Hospital

Pusan, Busanjin-gu, Gaegeum-dong, South Korea

Site Status RECRUITING

Asan Medical Center

Seoul, Pungnap-2dong, Songpagu, South Korea

Site Status RECRUITING

Eulji University Hospital

Daejeon, Seo-gu, Dunsan-dong, South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Do Hyun Park, MD

Role: CONTACT

+82-2-3010-3180

Tae Hoon Lee, MD

Role: CONTACT

+82-41-570-3662

Facility Contacts

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Tae Hoon Lee, MD

Role: primary

+82-41-570-3662

Jung Sik Choi, MD

Role: primary

+82-51-890-6114

Do Hyun Park, MD

Role: primary

+82-2-3010-3180

Sang Woo Cha, MD

Role: primary

+82-42-611-3052

References

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Tringali A, Mutignani M, Perri V, Zuccala G, Cipolletta L, Bianco MA, Rotondano G, Philipper M, Schumacher B, Neuhaus H, Schmit A, Deviere J, Costamagna G. A prospective, randomized multicenter trial comparing DoubleLayer and polyethylene stents for malignant distal common bile duct strictures. Endoscopy. 2003 Dec;35(12):992-7. doi: 10.1055/s-2003-44601.

Reference Type BACKGROUND
PMID: 14648409 (View on PubMed)

Wagner HJ, Knyrim K, Vakil N, Klose KJ. Plastic endoprostheses versus metal stents in the palliative treatment of malignant hilar biliary obstruction. A prospective and randomized trial. Endoscopy. 1993 Mar;25(3):213-8. doi: 10.1055/s-2007-1010295.

Reference Type BACKGROUND
PMID: 7686100 (View on PubMed)

de Groen PC, Gores GJ, LaRusso NF, Gunderson LL, Nagorney DM. Biliary tract cancers. N Engl J Med. 1999 Oct 28;341(18):1368-78. doi: 10.1056/NEJM199910283411807. No abstract available.

Reference Type BACKGROUND
PMID: 10536130 (View on PubMed)

Yeoh KG, Zimmerman MJ, Cunningham JT, Cotton PB. Comparative costs of metal versus plastic biliary stent strategies for malignant obstructive jaundice by decision analysis. Gastrointest Endosc. 1999 Apr;49(4 Pt 1):466-71. doi: 10.1016/s0016-5107(99)70044-1.

Reference Type BACKGROUND
PMID: 10202060 (View on PubMed)

Chang WH, Kortan P, Haber GB. Outcome in patients with bifurcation tumors who undergo unilateral versus bilateral hepatic duct drainage. Gastrointest Endosc. 1998 May;47(5):354-62. doi: 10.1016/s0016-5107(98)70218-4.

Reference Type BACKGROUND
PMID: 9609426 (View on PubMed)

Davids PH, Groen AK, Rauws EA, Tytgat GN, Huibregtse K. Randomised trial of self-expanding metal stents versus polyethylene stents for distal malignant biliary obstruction. Lancet. 1992 Dec 19-26;340(8834-8835):1488-92. doi: 10.1016/0140-6736(92)92752-2.

Reference Type BACKGROUND
PMID: 1281903 (View on PubMed)

Prat F, Chapat O, Ducot B, Ponchon T, Pelletier G, Fritsch J, Choury AD, Buffet C. A randomized trial of endoscopic drainage methods for inoperable malignant strictures of the common bile duct. Gastrointest Endosc. 1998 Jan;47(1):1-7. doi: 10.1016/s0016-5107(98)70291-3.

Reference Type BACKGROUND
PMID: 9468416 (View on PubMed)

Cheng JL, Bruno MJ, Bergman JJ, Rauws EA, Tytgat GN, Huibregtse K. Endoscopic palliation of patients with biliary obstruction caused by nonresectable hilar cholangiocarcinoma: efficacy of self-expandable metallic Wallstents. Gastrointest Endosc. 2002 Jul;56(1):33-9. doi: 10.1067/mge.2002.125364.

Reference Type BACKGROUND
PMID: 12085032 (View on PubMed)

Other Identifiers

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SCH-2010-04

Identifier Type: -

Identifier Source: org_study_id

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