A Prospective Randomized Controlled Multicenter Trial of Delayed Gastric Emptying (DGE) After Pancreaticoduodenectomy Evaluating by Gastrointestinal Reconstruction

NCT ID: NCT01460550

Last Updated: 2015-04-01

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

240 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-11-30

Study Completion Date

2017-03-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this study is to evaluate the incidence of delayed gastric emptying in patient with pancreaticoduodenectomy between antecolic and retrocolic gastrointestinal reconstruction.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The purpose of this study is to evaluate the incidence of delayed gastric emptying in patient with pancreaticoduodenectomy between antecolic and retrocolic gastrointestinal reconstruction. Delayed gastric emptying after pancreaticoduodenectomy is important to affect the postoperative course and QOL. We conducted a prospective randomized trial on 240 patients who underwent pancreaticoduodenectomy for comparing between antecolic and retrocolic gastrointestinal reconstruction.

The primary endpoint was defined as incidence of delayed gastric emptying by ISGPS criteria. The secondary endpoint was defined as incidence of other postoperative morbidity. Patients were recruited into this study before surgery, on the basis of whether pancreatic head resection was anticipated for pancreatic head and periampullary disease, and an appropriate informed consent was obtained. Exclusion criteria was 1) patients who have the history of gastrectomy, 2) patients who have severe cardiorespiratory dysfunction, 3) patients who have liver cirrhosis or are receiving dialysis, and 4) patients who were diagnosed inadequate for this study by a physician.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Postprocedural Delayed Gastric Emptying

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

gastrointestinal reconstruction

Group Type EXPERIMENTAL

Retrocolic gastro- or duodeno- jejunostomy in hte pancreaticoduodenectomy

Intervention Type PROCEDURE

The duodenojejunostomy or gastrojejunostomy was constructed in two layers or single layer. For the retrocolic reconstruction, the jejunal loop was anastomosed to the duodenum or stomach through a separate mesocolic window on the left of the middle colic vessels.

Antecolic gastro- or duodeno- jejunostomy in the pancreaticoduodenectomy

Intervention Type PROCEDURE

The duodenojejunostomy or gastrojejunostomy was constructed in two layers or single layer. For the antecolic reconstruction, the jejunal loop about 30 cm distal to the hepaticojejunostomy, was brought up anterior to the transverse colon and anastomosed to the duodenum or stomach.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Retrocolic gastro- or duodeno- jejunostomy in hte pancreaticoduodenectomy

The duodenojejunostomy or gastrojejunostomy was constructed in two layers or single layer. For the retrocolic reconstruction, the jejunal loop was anastomosed to the duodenum or stomach through a separate mesocolic window on the left of the middle colic vessels.

Intervention Type PROCEDURE

Antecolic gastro- or duodeno- jejunostomy in the pancreaticoduodenectomy

The duodenojejunostomy or gastrojejunostomy was constructed in two layers or single layer. For the antecolic reconstruction, the jejunal loop about 30 cm distal to the hepaticojejunostomy, was brought up anterior to the transverse colon and anastomosed to the duodenum or stomach.

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* patients with pancreatic-biliary disease who undergo pancreaticoduodenectomy

Exclusion Criteria

* patients who have the history of gastrectomy
* patients who have severe cardiorespiratory dysfunction
* patients who have liver cirrhosis or are receiving dialysis
* patients who were diagnosed inadequacy for this study by a physician
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Kobe University

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Ippei Matsumoto

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Yonson Ku, MD

Role: STUDY_CHAIR

Kobe University

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Kobe University

Kobe, Hyōgo, Japan

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Japan

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Ippei Matsumoto, MD

Role: CONTACT

+81-78-382-6302

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Ippei Matsumoto, MD

Role: primary

+81-78382-6302

References

Explore related publications, articles, or registry entries linked to this study.

DeOliveira ML, Winter JM, Schafer M, Cunningham SC, Cameron JL, Yeo CJ, Clavien PA. Assessment of complications after pancreatic surgery: A novel grading system applied to 633 patients undergoing pancreaticoduodenectomy. Ann Surg. 2006 Dec;244(6):931-7; discussion 937-9. doi: 10.1097/01.sla.0000246856.03918.9a.

Reference Type BACKGROUND
PMID: 17122618 (View on PubMed)

Wente MN, Bassi C, Dervenis C, Fingerhut A, Gouma DJ, Izbicki JR, Neoptolemos JP, Padbury RT, Sarr MG, Traverso LW, Yeo CJ, Buchler MW. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 2007 Nov;142(5):761-8. doi: 10.1016/j.surg.2007.05.005.

Reference Type BACKGROUND
PMID: 17981197 (View on PubMed)

Akizuki E, Kimura Y, Nobuoka T, Imamura M, Nagayama M, Sonoda T, Hirata K. Reconsideration of postoperative oral intake tolerance after pancreaticoduodenectomy: prospective consecutive analysis of delayed gastric emptying according to the ISGPS definition and the amount of dietary intake. Ann Surg. 2009 Jun;249(6):986-94. doi: 10.1097/SLA.0b013e3181a63c4c.

Reference Type BACKGROUND
PMID: 19474680 (View on PubMed)

Welsch T, Borm M, Degrate L, Hinz U, Buchler MW, Wente MN. Evaluation of the International Study Group of Pancreatic Surgery definition of delayed gastric emptying after pancreatoduodenectomy in a high-volume centre. Br J Surg. 2010 Jul;97(7):1043-50. doi: 10.1002/bjs.7071.

Reference Type BACKGROUND
PMID: 20632270 (View on PubMed)

Hayashibe A, Kameyama M, Shinbo M, Makimoto S. The surgical procedure and clinical results of subtotal stomach preserving pancreaticoduodenectomy (SSPPD) in comparison with pylorus preserving pancreaticoduodenectomy (PPPD). J Surg Oncol. 2007 Feb 1;95(2):106-9. doi: 10.1002/jso.20608.

Reference Type BACKGROUND
PMID: 17262740 (View on PubMed)

Hashimoto Y, Traverso LW. Incidence of pancreatic anastomotic failure and delayed gastric emptying after pancreatoduodenectomy in 507 consecutive patients: use of a web-based calculator to improve homogeneity of definition. Surgery. 2010 Apr;147(4):503-15. doi: 10.1016/j.surg.2009.10.034. Epub 2009 Dec 16.

Reference Type BACKGROUND
PMID: 20018335 (View on PubMed)

Park JS, Hwang HK, Kim JK, Cho SI, Yoon DS, Lee WJ, Chi HS. Clinical validation and risk factors for delayed gastric emptying based on the International Study Group of Pancreatic Surgery (ISGPS) Classification. Surgery. 2009 Nov;146(5):882-7. doi: 10.1016/j.surg.2009.05.012. Epub 2009 Jul 18.

Reference Type BACKGROUND
PMID: 19744455 (View on PubMed)

Tran KT, Smeenk HG, van Eijck CH, Kazemier G, Hop WC, Greve JW, Terpstra OT, Zijlstra JA, Klinkert P, Jeekel H. Pylorus preserving pancreaticoduodenectomy versus standard Whipple procedure: a prospective, randomized, multicenter analysis of 170 patients with pancreatic and periampullary tumors. Ann Surg. 2004 Nov;240(5):738-45. doi: 10.1097/01.sla.0000143248.71964.29.

Reference Type BACKGROUND
PMID: 15492552 (View on PubMed)

Akizuki E, Kimura Y, Nobuoka T, Imamura M, Nishidate T, Mizuguchi T, Furuhata T, Hirata K. Prospective nonrandomized comparison between pylorus-preserving and subtotal stomach-preserving pancreaticoduodenectomy from the perspectives of DGE occurrence and postoperative digestive functions. J Gastrointest Surg. 2008 Jul;12(7):1185-92. doi: 10.1007/s11605-008-0513-z. Epub 2008 Apr 22.

Reference Type BACKGROUND
PMID: 18427904 (View on PubMed)

Murakami H, Suzuki H, Nakamura T. Pancreatic fibrosis correlates with delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy with pancreaticogastrostomy. Ann Surg. 2002 Feb;235(2):240-5. doi: 10.1097/00000658-200202000-00012.

Reference Type BACKGROUND
PMID: 11807364 (View on PubMed)

Riediger H, Makowiec F, Schareck WD, Hopt UT, Adam U. Delayed gastric emptying after pylorus-preserving pancreatoduodenectomy is strongly related to other postoperative complications. J Gastrointest Surg. 2003 Sep-Oct;7(6):758-65. doi: 10.1016/s1091-255x(03)00109-4.

Reference Type BACKGROUND
PMID: 13129553 (View on PubMed)

Horstmann O, Markus PM, Ghadimi MB, Becker H. Pylorus preservation has no impact on delayed gastric emptying after pancreatic head resection. Pancreas. 2004 Jan;28(1):69-74. doi: 10.1097/00006676-200401000-00011.

Reference Type BACKGROUND
PMID: 14707733 (View on PubMed)

Yeo CJ, Cameron JL, Lillemoe KD, Sohn TA, Campbell KA, Sauter PK, Coleman J, Abrams RA, Hruban RH. Pancreaticoduodenectomy with or without distal gastrectomy and extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma, part 2: randomized controlled trial evaluating survival, morbidity, and mortality. Ann Surg. 2002 Sep;236(3):355-66; discussion 366-8. doi: 10.1097/00000658-200209000-00012.

Reference Type BACKGROUND
PMID: 12192322 (View on PubMed)

Park YC, Kim SW, Jang JY, Ahn YJ, Park YH. Factors influencing delayed gastric emptying after pylorus-preserving pancreatoduodenectomy. J Am Coll Surg. 2003 Jun;196(6):859-65. doi: 10.1016/S1072-7515(03)00127-3.

Reference Type BACKGROUND
PMID: 12788421 (View on PubMed)

Chijiiwa K, Imamura N, Ohuchida J, Hiyoshi M, Nagano M, Otani K, Kai M, Kondo K. Prospective randomized controlled study of gastric emptying assessed by (13)C-acetate breath test after pylorus-preserving pancreaticoduodenectomy: comparison between antecolic and vertical retrocolic duodenojejunostomy. J Hepatobiliary Pancreat Surg. 2009;16(1):49-55. doi: 10.1007/s00534-008-0004-3. Epub 2008 Dec 16.

Reference Type BACKGROUND
PMID: 19083149 (View on PubMed)

Hartel M, Wente MN, Hinz U, Kleeff J, Wagner M, Muller MW, Friess H, Buchler MW. Effect of antecolic reconstruction on delayed gastric emptying after the pylorus-preserving Whipple procedure. Arch Surg. 2005 Nov;140(11):1094-9. doi: 10.1001/archsurg.140.11.1094.

Reference Type BACKGROUND
PMID: 16301447 (View on PubMed)

Nikfarjam M, Kimchi ET, Gusani NJ, Shah SM, Sehmbey M, Shereef S, Staveley-O'Carroll KF. A reduction in delayed gastric emptying by classic pancreaticoduodenectomy with an antecolic gastrojejunal anastomosis and a retrogastric omental patch. J Gastrointest Surg. 2009 Sep;13(9):1674-82. doi: 10.1007/s11605-009-0944-1. Epub 2009 Jun 23.

Reference Type BACKGROUND
PMID: 19548039 (View on PubMed)

Tani M, Terasawa H, Kawai M, Ina S, Hirono S, Uchiyama K, Yamaue H. Improvement of delayed gastric emptying in pylorus-preserving pancreaticoduodenectomy: results of a prospective, randomized, controlled trial. Ann Surg. 2006 Mar;243(3):316-20. doi: 10.1097/01.sla.0000201479.84934.ca.

Reference Type BACKGROUND
PMID: 16495694 (View on PubMed)

Toyama H, Matsumoto I, Mizumoto T, Fujita H, Tsuchida S, Kanbara Y, Kadowaki Y, Maeda H, Okano K, Fukuoka M, Takase S, Shirakawa S, Terai S, Mukubo H, Ishida J, Yamashita H, Ueno K, Tanaka M, Kido M, Ajiki T, Murakami S, Nishimura K, Fukumoto T. Influence of the Retrocolic Versus Antecolic Route for Alimentary Tract Reconstruction on Delayed Gastric Emptying After Pancreatoduodenectomy: A Multicenter, Noninferiority Randomized Controlled Trial. Ann Surg. 2021 Dec 1;274(6):935-944. doi: 10.1097/SLA.0000000000004072.

Reference Type DERIVED
PMID: 32773628 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

http://www.med.kobe-u.ac.jp/hbps/index.html

Click here for more information about this study: Clinical Trial of DGE after PD

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

KOPAS01

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

A Prospective Observational Study of TPIAT
NCT03260387 ACTIVE_NOT_RECRUITING