EUS-guided Transmural Drainage of Walled-off Pancreatic Necrosis: Plastic vs Metallic Protesis.

NCT ID: NCT03100578

Last Updated: 2021-11-10

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

99 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-06-27

Study Completion Date

2021-10-30

Brief Summary

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Randomized multicenter study comparing plastic stents and self-expanding metallic stents in the eus-guided transmural drainage of walled-off pancreatic necrosis.

Spanish centers partners of the spanish society of digestive endoscopy.

Detailed Description

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Conditions

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Pancreas Necrosis Pancreatic Collection

Keywords

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PANCREAS ENDOSCOPIC INTERVENTION PLASTIC STENT SELF EXPANDING METALLIC STENT ENDOSCOPIC TRANSMURAL DRAINAGE WALLED OFF PANCREATIC NECROSIS

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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PLASTIC STENT

Endoscopic double pigtail plastic stent, with formal indication on pancreatic collection, according to the instruction forms of the manufacturer.

Interventions associated:

EUS-guided transmural drainage of pancretic collection: PLASTIC STENT.

Group Type EXPERIMENTAL

WOPN TRANSMURAL DRAINAGE: PLASTIC STENT

Intervention Type DEVICE

Endoscopic ultrasound-guided transmural drainage of walled-off pancreatic necrosis:

The pancreatic collection will be located with the linear echoendoscope, and we will proceed to choose an optimal area to perform the puncture guided by EUS; with the absence of intervening vessels.

This collection will be punctured with a 19 G needle or with an electrocautery device directly. Guidance will be advanced through the needle and the ostomy will proceed according to the routine of the experienced endoscopist.

Placement of a plastic double pigtail, 5-10 cm in length, diameters 7-8,5-10 Fr. Minimum one 10 Fr prosthesis.

Arm associated: PLASTIC STENT

SELF EXPANDABLE METALLIC STENT

Lumen apposing metal stent with formal indicaction on pancreatic collection, according to the manufacturer instruction forms.

Interventions associated:

EUS-guided transmural drainage of pancretic collection: METALLIC STENT.

Group Type ACTIVE_COMPARATOR

WOPN TRANSMURAL DRAINAGE: METALLIC STENT

Intervention Type DEVICE

Endoscopic ultrasound-guided transmural drainage of walled-off pancreatic necrosis:

The pancreatic collection will be located with the linear echoendoscope, and we will proceed to choose an optimal area to perform the puncture guided by EUS; with the absence of intervening vessels.

This collection will be punctured with a 19 G needle or with an electrocautery device directly. Guidance will be advanced through the needle and the ostomy will proceed according to the routine of the experienced endoscopist.

Placement of a metal self-expanding fully covered luminal apposition stent: 10, 15 or 20 mm diameter.

Arm associated: SELF EXPANDABLE METALLIC STENT

Interventions

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WOPN TRANSMURAL DRAINAGE: PLASTIC STENT

Endoscopic ultrasound-guided transmural drainage of walled-off pancreatic necrosis:

The pancreatic collection will be located with the linear echoendoscope, and we will proceed to choose an optimal area to perform the puncture guided by EUS; with the absence of intervening vessels.

This collection will be punctured with a 19 G needle or with an electrocautery device directly. Guidance will be advanced through the needle and the ostomy will proceed according to the routine of the experienced endoscopist.

Placement of a plastic double pigtail, 5-10 cm in length, diameters 7-8,5-10 Fr. Minimum one 10 Fr prosthesis.

Arm associated: PLASTIC STENT

Intervention Type DEVICE

WOPN TRANSMURAL DRAINAGE: METALLIC STENT

Endoscopic ultrasound-guided transmural drainage of walled-off pancreatic necrosis:

The pancreatic collection will be located with the linear echoendoscope, and we will proceed to choose an optimal area to perform the puncture guided by EUS; with the absence of intervening vessels.

This collection will be punctured with a 19 G needle or with an electrocautery device directly. Guidance will be advanced through the needle and the ostomy will proceed according to the routine of the experienced endoscopist.

Placement of a metal self-expanding fully covered luminal apposition stent: 10, 15 or 20 mm diameter.

Arm associated: SELF EXPANDABLE METALLIC STENT

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age greater than or equal to 18 years
* Patient with indication (ASGE, Jacobson BC, GIE2005;) of pancreatic collection drainage type WALLED-OFF PANCREATIC NECROSIS \* as a local complication of previous acute pancreatitis.
* Patient trained to understand and / or sign informed consent
* Patient who understands the type of study and will comply with all follow-up of complementary tests during its duration

Exclusion Criteria

* Pregnancy or breastfeeding
* Severe coagulation disorder: INR\> 1.5 not correctable with plasma and / or platelet administration \<50,000 / mm3
* Asymptomatic patients, with no clinical indication of drainage, except for those with vascular involvement due to compression (eg stenosis, splenic vessels with collateral circulation, and risk of bleeding)
* Non-identification of solid content during the Endoscopic Ultrasound of the procedure
* No informed consent
* In the case of patients with mental retardation, without the ability to understand the nature and possible consequences of the study, except for the existence of a legal representative
* Patients unable to maintain posterior follow-up (lack of adherence)
* Situations that do not allow the practice of a high digestive endoscopy (eg, stenosis)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Carlos III Health Institute

OTHER_GOV

Sponsor Role collaborator

Spanish Clinical Research Network - SCReN

NETWORK

Sponsor Role collaborator

Hospital Universitari de Bellvitge

OTHER

Sponsor Role lead

Responsible Party

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Joan B Gornals

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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JOAN B GORNALS, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Universitari de Bellvitge - IDIBELL

Locations

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Hospital Arnau de Vilanova

Lleida, Barcelona, Spain

Site Status

Hospital Universitario Marqués de Valdecilla

Santander, Cantabria, Spain

Site Status

Hospital Costa del Sol

Marbella, Málaga, Spain

Site Status

Hospital San Juan de Dios

Pamplona, Navarre, Spain

Site Status

Hospital Universitario Río Hortega

Valladolid, Valldolid, Spain

Site Status

Hospital de la Santa Creu i Sant Pau

Barcelona, , Spain

Site Status

Hospital Universitario Ramón y Cajal

Madrid, , Spain

Site Status

Hospital Clínico San Carlos

Madrid, , Spain

Site Status

Countries

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Spain

References

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Gornals JB, Velasquez-Rodriguez JG, Bas-Cutrina F, Garcia Garcia De Paredes A, Esteban JM, Teran A, Gonzalez-Huix F, Perez-Miranda M, Guarner-Argente C, Vila JJ, Garcia-Sumalla A, Foruny JR, Fisac-Vazquez J, Moris M, Miquel-Salas I, De-la-Serna Higuera C, Murzi-Pulgar M, Sanchez-Yague A, Salord S, Ruiz-Osuna S, Busquets J, Sanllorente-Melenchon M, Videla S, Moreno R, Tebe-Cordomi C, Hereu P, Vazquez-Sequeiros E; Spanish Working Group on Pancreatic Collection Therapy. Plastic pigtail vs lumen-apposing metal stents for drainage of walled-off necrosis (PROMETHEUS study): an open-label, multicenter randomized trial. Surg Endosc. 2024 Apr;38(4):2148-2159. doi: 10.1007/s00464-024-10699-w. Epub 2024 Mar 6.

Reference Type DERIVED
PMID: 38448625 (View on PubMed)

Gornals JB, Perez-Miranda M, Vazquez-Sequeiros E, Vila J, Esteban JM, Gonzalez-Huix F, Guarner-Argente C, Sanchez-Yague A, Teran A, Bas-Cutrina F, De La Serna C, De Paredes AG, Ballester R, Velasquez-Rodriguez J, Salord S, Tebe C, Hereu P, Videla S; Spanish Working Group on Pancreatic Collection Therapy. Multicenter study of plastic vs. self-expanding metal stents in endoscopic ultrasound-guided drainage of walled-off pancreatic necrosis - PROMETHEUS: a randomized controlled trial protocol. Trials. 2019 Dec 30;20(1):791. doi: 10.1186/s13063-019-3988-x.

Reference Type DERIVED
PMID: 31888751 (View on PubMed)

Other Identifiers

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PROMETHEUS

Identifier Type: -

Identifier Source: org_study_id