Endoscopic Treatment of Benign Biliary Strictures and Cystic Duct Leakages With a Novel Biodegradable Biliary Stent

NCT ID: NCT02353286

Last Updated: 2018-05-14

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

COMPLETED

Clinical Phase

NA

Total Enrollment

14 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-05-31

Study Completion Date

2017-12-31

Brief Summary

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Patients with either post-cholecystectomy bile leak or benign biliary stricture are recruited for endoscopic insertion of a biodegradable biliary stent. A follow-up of 12 months with repeated serum samples and magnetic resonance imaging is scheduled. The primary end points are feasibility of endoscopic insertion with the novel implantation device and stricture or leak resolution as well as clinical treatment success.

Detailed Description

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Benign biliary strictures (BBS) and post-cholecystectomy bile leaks have traditionally been treated endoscopically with plastic stents. In BBS, promising results of covered self-expanding metal stent use have been recently published. However, in both BBS and post-cholecystectomy bile leak the need of stent therapy is temporary and endoscopic stent exchange or removal is unavoidable. These two groups of patients may be the ones that would most obviously benefit from biodegradable (BD) biliary stents. Studies of BD stents on animal models have shown excellent long term patency and safety both in biliary and pancreatic duct as well better outcome compared to plastic stents after post-cholecystectomy bile leak in an animal study. Until recently, non-operative insertion of BD polydioxanone stent in human biliary tract has been possible only via percutaneous route.

With the novel implantation device, the BD stents (braided, self-expanding polydioxanone stent, 8 x 40-60mm, Ella, Czech republic) may be used endoscopically during endoscopic retrograde cholangio-pancreatography (ERCP).

The hypothesis is that larger diameter and radial expansion strength provide at least similar treatment success as the current method of endoscopic insertion of plastic or covered self-expanding metal stents in bile leak and BBS, respectively. However, later stent exchange or removal is not necessary with BD stents.

Conditions

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Biliary Tract Diseases

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Post-cholecystecomy bile leak

Endoscopic insertion of biodegradable biliary stent

Group Type EXPERIMENTAL

Endoscopic insertion of biodegradable biliary stent

Intervention Type DEVICE

Endoscopic insertion of biodegradable biliary stent

Benign biliary stricture

Endoscopic insertion of biodegradable biliary stent

Group Type EXPERIMENTAL

Endoscopic insertion of biodegradable biliary stent

Intervention Type DEVICE

Endoscopic insertion of biodegradable biliary stent

Interventions

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Endoscopic insertion of biodegradable biliary stent

Endoscopic insertion of biodegradable biliary stent

Intervention Type DEVICE

Other Intervention Names

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Braided, self-expanding polydioxanone stent, Ella, Czech Rep

Eligibility Criteria

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Inclusion Criteria

* informed-consent patients with diagnosed or suspected post-cholecystectomy biliary leak or benign biliary stricture.

Exclusion Criteria

* Patients with contra-indications for magnetic resonance imaging (MRI) or surgically altered gastro-duodenal anatomy (e.g. roux-y-loop) are excluded from the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Tampere University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Antti Siiki

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Johanna Laukkarinen, Md, PhD

Role: STUDY_DIRECTOR

Dept. of Gastroenterology and Alimentary Tract Surgery

Juhani Sand, Md, PhD

Role: STUDY_DIRECTOR

Dept. of Gastroenterology and Alimentary Tract Surgery

Locations

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Tampere University Hospital, Dept. of Gastroenterology and Alimentary Tract Surgery

Tampere, , Finland

Site Status

Countries

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Finland

References

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Mauri G, Michelozzi C, Melchiorre F, Poretti D, Tramarin M, Pedicini V, Solbiati L, Cornalba G, Sconfienza LM. Biodegradable biliary stent implantation in the treatment of benign bilioplastic-refractory biliary strictures: preliminary experience. Eur Radiol. 2013 Dec;23(12):3304-10. doi: 10.1007/s00330-013-2947-2. Epub 2013 Jul 11.

Reference Type BACKGROUND
PMID: 23842947 (View on PubMed)

Laukkarinen J, Nordback I, Mikkonen J, Karkkainen P, Sand J. A novel biodegradable biliary stent in the endoscopic treatment of cystic-duct leakage after cholecystectomy. Gastrointest Endosc. 2007 Jun;65(7):1063-8. doi: 10.1016/j.gie.2006.11.059.

Reference Type BACKGROUND
PMID: 17531643 (View on PubMed)

Grolich T, Crha M, Novotny L, Kala Z, Hep A, Necas A, Hlavsa J, Mitas L, Misik J. Self-expandable biodegradable biliary stents in porcine model. J Surg Res. 2015 Feb;193(2):606-12. doi: 10.1016/j.jss.2014.08.006. Epub 2014 Aug 9.

Reference Type BACKGROUND
PMID: 25201575 (View on PubMed)

Lorenzo-Zuniga V, Moreno-de-Vega V, Marin I, Boix J. Biodegradable stents in gastrointestinal endoscopy. World J Gastroenterol. 2014 Mar 7;20(9):2212-7. doi: 10.3748/wjg.v20.i9.2212.

Reference Type BACKGROUND
PMID: 24605020 (View on PubMed)

Siiki A, Rinta-Kiikka I, Sand J, Laukkarinen J. A pilot study of endoscopically inserted biodegradable biliary stents in the treatment of benign biliary strictures and cystic duct leaks. Gastrointest Endosc. 2018 Apr;87(4):1132-1137. doi: 10.1016/j.gie.2017.10.042. Epub 2017 Nov 8.

Reference Type DERIVED
PMID: 29128386 (View on PubMed)

Siiki A, Rinta-Kiikka I, Sand J, Laukkarinen J. Biodegradable biliary stent in the endoscopic treatment of cystic duct leak after cholecystectomy: the first case report and review of literature. J Laparoendosc Adv Surg Tech A. 2015 May;25(5):419-22. doi: 10.1089/lap.2015.0068. Epub 2015 Apr 8.

Reference Type DERIVED
PMID: 25853929 (View on PubMed)

Other Identifiers

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Biodegradable Biliary stent

Identifier Type: -

Identifier Source: org_study_id

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