Comparison of Endoscopic Sphincterotomy Plus Large-balloon Dilatation and Conventional Treatment for Large CBD Stones

NCT ID: NCT02592811

Last Updated: 2015-10-30

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

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-07-31

Study Completion Date

2015-03-31

Brief Summary

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

Bile duct stone extraction is impossible after endoscopic sphincterotomy (ES) alone in approximatively 10% of cases (mostly because of stones' size). Adjunction of a mechanical lithotripsy (ML) is well established to improve clearance of common bile duct (CBD) stones. Because of inconstant success, high cost, and length of procedure, an alternative method was proposed in 2003: endoscopic sphincterotomy plus large balloon dilatation (ESLBD). If the safety of ESLBD is accepted in all recent published studies, it remains controversial wether ESLBD is superior to conventional endoscopic treatment associating ES± ML for CBD stones. Procedure treatment and place of ESLBD in CBD stones therapeutic strategy is unclear.

The purpose of this prospective comparative multi center randomized study is to evaluate the superiority or not of ESLBD on conventional treatment (ES±ML) for the treatment of large bile duct stone (≥13mm) after standard ES, and to propose a new CBD stones therapeutic strategy.

Detailed Description

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

Conditions

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

Choledocholithiasis Large Common Bile Duct Stone

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Cholangiopancreatography therapeutic strategy Endoscopic Retrograde

Study Design

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

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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

ESLBD

Endoscopic Sphincterotomy plus Large Balloon Dilatation +/- lithotripsy

1. ERCP with deep cancellation of BDS
2. Endoscopic large sphincterotomy
3. Large Balloon Dilatation of Oddi Sphincter: with the HERCULES, Cook 12, 15, 18 or 20 mm of diameter (adapted to stone diameter)
4. Stone extraction with dormia basket or extraction balloon
5. Mechanical Lithotripsy if needed

Group Type ACTIVE_COMPARATOR

ERCP

Intervention Type PROCEDURE

Common bile duct cannulation with a cannulation catheter

Endoscopic Sphincterotomy

Intervention Type PROCEDURE

Endoscopic large sphincterotomy

Large Balloon Dilatation of Oddi Sphincter

Intervention Type DEVICE

Large Balloon Dilatation : with the HERCULES, Cook 12, 15, 18 or 20 mm of diameter (adapted to stone diameter)

Stone extraction

Intervention Type PROCEDURE

After dilatation, extraction of stones is done with dormia basket or extraction balloon and if not possible a mechanical lithotripsy is performed

CONV

Conventional treatment associating Endoscopic Sphincterotomy +/- Mechanical Lithotripsy (ES+/-LM)

1. ERCP with deep cancellation of BDS
2. Endoscopic large sphincterotomy
3. Stone extraction with dormia basket or extraction balloon
4. Mechanical Lithotripsy if needed

Group Type ACTIVE_COMPARATOR

ERCP

Intervention Type PROCEDURE

Common bile duct cannulation with a cannulation catheter

Endoscopic Sphincterotomy

Intervention Type PROCEDURE

Endoscopic large sphincterotomy

Stone extraction

Intervention Type PROCEDURE

After dilatation, extraction of stones is done with dormia basket or extraction balloon and if not possible a mechanical lithotripsy is performed

Interventions

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

ERCP

Common bile duct cannulation with a cannulation catheter

Intervention Type PROCEDURE

Endoscopic Sphincterotomy

Endoscopic large sphincterotomy

Intervention Type PROCEDURE

Large Balloon Dilatation of Oddi Sphincter

Large Balloon Dilatation : with the HERCULES, Cook 12, 15, 18 or 20 mm of diameter (adapted to stone diameter)

Intervention Type DEVICE

Stone extraction

After dilatation, extraction of stones is done with dormia basket or extraction balloon and if not possible a mechanical lithotripsy is performed

Intervention Type PROCEDURE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Cholangiogram with deep cannulation of CBD ES LBD, LBDS

Eligibility Criteria

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

Inclusion Criteria

* Patient with CBD stones with a smaller diameter ≥ 13mm on cholangiogram

Exclusion Criteria

* Active or history of acute pancreatitis
* Presence of intrahepatic stones
* History of Billroth II or roux-en-Y reconstruction
* Coagulation disorder (partial thromboplastin time \> 42 seconds, prothrombin time (Quick value) \< 50% and platelet count of \<50 000/mm3)
* Current anticoagulation or clopidogrel treatment
* Pregnancy
* Inability to give informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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

Société Française d'Endoscopie Digestive

OTHER

Sponsor Role lead

Responsible Party

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

KARSENTI

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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

David KARSENTI, MD

Role: PRINCIPAL_INVESTIGATOR

Société Française d'Endoscopie Digestive

References

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

Karsenti D, Coron E, Vanbiervliet G, Privat J, Kull E, Bichard P, Perrot B, Quentin V, Duriez A, Cholet F, Subtil C, Duchmann JC, Lefort C, Hudziak H, Koch S, Granval P, Lecleire S, Charachon A, Barange K, Cesbron EM, De Widerspach A, Le Baleur Y, Barthet M, Poincloux L. Complete endoscopic sphincterotomy with vs. without large-balloon dilation for the removal of large bile duct stones: randomized multicenter study. Endoscopy. 2017 Oct;49(10):968-976. doi: 10.1055/s-0043-114411. Epub 2017 Jul 28.

Reference Type DERIVED
PMID: 28753698 (View on PubMed)

Other Identifiers

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

SocieteFranceED

Identifier Type: -

Identifier Source: org_study_id