ESWL Versus ESWL and Endoscopic Treatment

NCT ID: NCT02971475

Last Updated: 2018-06-01

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

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

62 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-11-30

Study Completion Date

2019-07-31

Brief Summary

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The study wants to compare ESWL alone with ESWL and endoscopic drainage of the MPD for treatment of pain in chronic pancreatitis.

Detailed Description

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The combination mode of ESWL and ERCP is an established method of treatment of painful obstructive calcified chronic pancreatitis. However, the investigators notice that patients after ESWL alone in calcified CP is followed by spontaneous elimination of stone fragments and pain relief. Inui reported that 40% of 555 patients spontaneous eliminate stone fragments. Dumonceau found that combining systematic endoscopy with ESWL adds to the cost of patient care, without improving the outcome of the pancreatic pain.

So the investigators design such a prospective and randomized controlled trial. People diagnosed with uncomplicated painful chronic pancreatitis and calcifications obstructing the MPD will be randomly assigned to the ESWL or endoscopy group according to a table of random numbers.

ESWL will be performed in all patients using a electromagnetic lithotriptor. ESWL sessions will be repeated if necessary, until stone fragmentation is obtained. Patients in the endoscopy group will undergo endoscopy in 48 hours with possible stent insertion. In the ESWL group, if pain continues or aggravates, endoscopic drainage of the MPD will be carried out.

Follow-up will consists of telephone interview1 after treatment and clinical examination every 6 months thereafter. Data collected will include clinical presentation, ESWL, endoscopic and surgical procedures, life quality. In addition, S-MRCP will be performed 6 months after treatment. Blood glucose, insulin, stool elastase will be taken each clinical examination.

Conditions

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Pancreatitis

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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ESWL alone

Patients in this group would be treated with extracorporeal shock wave lithotripsy only. Otherwise, extra endoscopic procedures will be carried out in case of continuous and aggravated pain. Analgesics will be administrated as needed and recorded.

Group Type EXPERIMENTAL

extracorporeal shock wave lithotripsy

Intervention Type PROCEDURE

People in this group would be treated with ESWL only.

Analgesics

Intervention Type DRUG

Analgesics administrated include morphine, buprenorphine, pethidine, tramaldol, metamizole and acetylsalicylacid. They will only be administrated as needed.

ESWL combined with ERCP

People in this group would be treated with ESWL followed be endoscopic drainage of the main pancreatic duct in 48 hours. Analgesics will be administrated as needed and recorded.

Group Type ACTIVE_COMPARATOR

endoscopic drainage of the main pancreatic duct

Intervention Type PROCEDURE

People in this group would be treated with ESWL followed be endoscopic drainage in 48 hours.

Analgesics

Intervention Type DRUG

Analgesics administrated include morphine, buprenorphine, pethidine, tramaldol, metamizole and acetylsalicylacid. They will only be administrated as needed.

Interventions

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extracorporeal shock wave lithotripsy

People in this group would be treated with ESWL only.

Intervention Type PROCEDURE

endoscopic drainage of the main pancreatic duct

People in this group would be treated with ESWL followed be endoscopic drainage in 48 hours.

Intervention Type PROCEDURE

Analgesics

Analgesics administrated include morphine, buprenorphine, pethidine, tramaldol, metamizole and acetylsalicylacid. They will only be administrated as needed.

Intervention Type DRUG

Other Intervention Names

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ESWL ERCP

Eligibility Criteria

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Inclusion Criteria

* painful chronic pancreatitis(abdominal pain attack during the preceding 12 months);
* at least 1 calcified stone greater than 5 mm in one of its axes in the cephalic or corporeal portion of the main pancreatic duct with upstream duct dilation;
* no ERCP or ESWL carried out before admission

Exclusion Criteria

* suspected to have malignant tumors;
* history of pancreatic surgery or gastrojejunostomy (Billroth II);
* pancreatic collection greater than 2 cm in diameter at magnetic resonance or CT scan;
* age below 18 years;
* pregnancy or lactation;
* refuse to write informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Changhai Hospital

OTHER

Sponsor Role lead

Responsible Party

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Zhuan Liao

Deputy Director

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Changhai Hospital

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Shanghai Changhai Hospital

Shanghai, , China

Site Status RECRUITING

Countries

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China

Central Contacts

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Zhao-shen Li

Role: CONTACT

Zhuan Liao

Role: CONTACT

Facility Contacts

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Yang-Yang Qian, MD

Role: primary

Zhao-shen Li

Role: primary

Zhuan Liao

Role: backup

Other Identifiers

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20160801

Identifier Type: -

Identifier Source: org_study_id

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