Intra-gallbladder or Systemic Indocyanide Green Injection Facilitate Cholecystectomy.

NCT ID: NCT03024892

Last Updated: 2018-07-23

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

600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-11-30

Study Completion Date

2018-10-31

Brief Summary

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The investigators will collect the pre-operative medical history and arrange physical examination, life quality evaluation, blood and biochemical test. The Patients with acute cholecytitis, gallstone or gallbladder polyp without interventional treatment or cholecystitis after percurtaneus gallbladder drainage(PTGBD) were involved in this study. Four laparoscopic ports were introduced and the pneumoperitoneum (12mmHg) was established. In study group , ICG was give by intra-gallbladder injection or systemic injection, the cholecystectomy were performed . In control group, no ICG was given and traditional cholecystectomy were performed. A near-infrared optimized laparoscope was used to detect the ICG fluorescence signal arising from gallbladder , cystic duct and common bile duct before cholecystectomy in study group. According to the enhancement of ICG, the cholecystectomy was started from cystic duct in Calot's triangle.Time to gallbladder removed was recorded. Conversion rate, post-operative morbidity and mortality will be recorded as well .

Detailed Description

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Back Ground:

Laparoscopic cholecystectomy(LC) is the one of most common procedure done by minimal invasive surgery worldwide but the common bile duct(CBD) injury still happened even the existence of standard technique with growing experience and new technology, especial in cholecystitis. Image guided surgery created new concept for fluorescent cholangiography to demonstrate the anatomy of CBD by using indocyanine green (ICG) intravenous injection before operation to decreased complication. The result is positive but the border of gallbladder can't be seen very well in systemic injection . In cholecystitis, the border between gallbladder and common bile duct is important as well as CBD and cystic duct.

Purpose:

The investigators hypothesized injection of ICG into gallbladder directly will be helpful to identify cystic duct, CBD and the border of gallbladder as well as systemic injection . The purpose of this study was to evaluate feasibility of this image guide surgery

Study Design:

The investigators will collect the pre-operative medical history and arrange physical examination, life quality evaluation, blood and biochemical test. The Patients with acute cholecytitis, gallstone or gallbladder polyp without interventional treatment or cholecystitis after percurtaneus gallbladder drainage(PTGBD) were involved in this study. Four laparoscopic ports were introduced and the pneumoperitoneum (12mmHg) was established. In study group , ICG was give by intra-gallbladder injection or systemic injection, the cholecystectomy were performed . In control group, no ICG was given and traditional cholecystectomy were performed. A near-infrared optimized laparoscope was used to detect the ICG fluorescence signal arising from gallbladder , cystic duct and common bile duct before cholecystectomy in study group. According to the enhancement of ICG, the cholecystectomy was started from cystic duct in Calot's triangle. Time to gallbladder removed was recorded. Conversion rate, post-operative morbidity and mortality will be recorded as well . The investigators intend to collect 600 patients. 150 patients will receive ICG injection via gallbladder as image guided surgery, 150 patients will receive ICG injection via systemic injection as image guided surgery , the other 300 patients who refuse will be the control group(150 patients for LC and 150 patients for LC + intra-operative cholangiography).

Expected results A. Publish Intra-gallbladder indocyanide green injection via drainage route facilitate cholecystectomy in acute cholecystitis。 B. Publish Comparison of systemic and intra-gallbladder injection of indocyanide green in benefit for cholecystectomy C. Extend to publish Near-infrared cholangiography decreased learning curve of laparoscopic cholecystectomy for medical student D. Near- infrared laparoscope education textbook and clinical case analysis

Conditions

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Fluorenscent Image Guided Surgery Indocyanide Green

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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ICG gallbladder

patients who received ICG injection via gallbladder and received fluroscence image guided surgery

Group Type EXPERIMENTAL

ICG GB

Intervention Type PROCEDURE

ICG was given by intra-gallbladder injection, then the near-infrared image guide laparoscopic cholecystectomy were performed.

ICG IV

patients who received ICG injection via peripheral vein and received fluroscence image guided surgery

Group Type EXPERIMENTAL

ICG IV

Intervention Type PROCEDURE

ICG was given by systemic injection, then the near-infrared image guide laparoscopic cholecystectomy were performed.

LC conventional

Patients received conventional laparoscopic cholecystectomy

Group Type SHAM_COMPARATOR

LC conventional

Intervention Type PROCEDURE

simple laparoscopic cholecystectomy was performed under white light image.

LC conventional and IOC

Patients received conventional laparoscopic cholecystectomy + intraoperative cholangiography

Group Type SHAM_COMPARATOR

LC conventional and IOC

Intervention Type PROCEDURE

simple laparoscopic cholecystectomy was performed under white light image and intraoperaitve cholangiography guidance.

Interventions

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ICG GB

ICG was given by intra-gallbladder injection, then the near-infrared image guide laparoscopic cholecystectomy were performed.

Intervention Type PROCEDURE

ICG IV

ICG was given by systemic injection, then the near-infrared image guide laparoscopic cholecystectomy were performed.

Intervention Type PROCEDURE

LC conventional

simple laparoscopic cholecystectomy was performed under white light image.

Intervention Type PROCEDURE

LC conventional and IOC

simple laparoscopic cholecystectomy was performed under white light image and intraoperaitve cholangiography guidance.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients with acute cholecytitis, gallstone or gallbladder polyp without interventional treatment or cholecystitis after percurtaneus gallbladder drainage(PTGBD) were involved in this study.

Exclusion Criteria

* a.Pregnancy and Breast feeding female.
* b.Patients have another severe medical diseases.(ex: heart failure, respiratory failure and stroke etc.)
* c.Not suitable for patients receiving anesthesia.
* d.Alcoholism, drug abuse and psychopaths.
* e.Iodine allergies and renal failure patients.
Minimum Eligible Age

20 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Chang Gung Memorial Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Chien-Hung Liao, MD

Role: PRINCIPAL_INVESTIGATOR

Chang Gung Memorial Hospital

Shang-Yu Wang, MD

Role: PRINCIPAL_INVESTIGATOR

Chang Gung Memorial Hospital

Locations

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Chang Gung Memorial Hospital

Niaosong, Kaohsiung, Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Yu-Yin Liu, MD

Role: CONTACT

+886975365627

Ta-Sen Yeh, PhD

Role: CONTACT

+886975368190

Facility Contacts

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Yu-Yin Liu, MD

Role: primary

+886975365627

References

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Shea JA, Healey MJ, Berlin JA, Clarke JR, Malet PF, Staroscik RN, Schwartz JS, Williams SV. Mortality and complications associated with laparoscopic cholecystectomy. A meta-analysis. Ann Surg. 1996 Nov;224(5):609-20. doi: 10.1097/00000658-199611000-00005.

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Other Identifiers

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CGMH-IRB-104-5333A3

Identifier Type: -

Identifier Source: org_study_id

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