Cholangioscopic Assessment of Occluded Biliary Stent and Role of Biliary Radiofrequency Ablation

NCT ID: NCT03133026

Last Updated: 2017-04-28

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

4 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-30

Study Completion Date

2018-07-31

Brief Summary

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Primary Objective: To document state-of- the-art multi-modality management of occluded biliary SEMS aiming to minimize number of reinterventions while providing symptom relief without procedure-related serious adverse events.

NOTE: This study will be hypothesis-generating for an anticipated randomized controlled study (RCT) to compare outcomes of placement of a plastic stent inside the occluded SEMS to outcomes of the proposed multi-modality approach.

Detailed Description

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Study Design:

Prospective, multi-center, single arm, post market, observational study

Two groups:

* Sludge group: SEMS occluded due to sludge/stones in SEMS
* Ingrowth/overgrowth group: SEMS occluded due to malignant tumor ingrowth or benign hyperplastic tissue overgrowth

Primary Endpoint:

Successful restoration of bile duct drainage with biliary obstructive symptom and cholangitis relief as applicable, without procedure related SAE'S, from procedure through 30 days of follow-up.

Secondary Endpoints:

1. Occurrence and severity of procedure related serious adverse events from procedure through 30 days after procedure
2. Resolution of cholangitis where applicable
3. Technical success of procedure performed for restoration of bile duct drainage, overall and stratified by treatment group Sludge group: Ability to restore stent patency by cleaning the stent content followed by cholangiographically or cholangioscopically confirmed restored stent patency Ingrowth / overgrowth group: Ability to perform biliary radio frequency ablation (RFA) followed by cholangiographically or cholangioscopically confirmed restored stent patency
4. Improvement of biliary obstructive symptoms at 1 week and 1 month post procedure compared to Baseline
5. Improvement of Laboratory Liver Function Tests (LFT) at 1 week and 1 month post procedure compared to Baseline
6. Biliary Reintervention rate from procedure through 30 days after procedure, including reinterventions caused by plastic stent occlusion
7. Impact of cholangioscopy on current standard of care, which is to place a stent inside the occluded SEMS by

* Avoiding placement of a second stent (plastic or metal)
* Avoiding a repeat ERCP
* Reducing associated cost

Conditions

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Obstructive Jaundice Cholangitis

Keywords

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obstructive Jaundice Self Expandable Metal Stents (SEMS) Cholangitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

SINGLE

Participants

Study Groups

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Sludge group

If Single operator cholangioscopy reveals only sludge then sludge will be cleared using conventional technique during ERCP.

Group Type ACTIVE_COMPARATOR

Single operator cholangioscopy, Endoscopic biliary RFA

Intervention Type DEVICE

Single operator cholangioscopy will be done to acess the cause of occluded SEMS, if tumour ingrowth or overgrowth seen then endoscopic biliary RFA will be done

Ingrowth / Overgrowth

If Single operator cholangioscopy reveals tumour ingrowth or overgrowth then to evaluate the role of biliary RFA for occluded stent due to tumour ingrowth or overgrowth

Group Type ACTIVE_COMPARATOR

Single operator cholangioscopy, Endoscopic biliary RFA

Intervention Type DEVICE

Single operator cholangioscopy will be done to acess the cause of occluded SEMS, if tumour ingrowth or overgrowth seen then endoscopic biliary RFA will be done

Interventions

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Single operator cholangioscopy, Endoscopic biliary RFA

Single operator cholangioscopy will be done to acess the cause of occluded SEMS, if tumour ingrowth or overgrowth seen then endoscopic biliary RFA will be done

Intervention Type DEVICE

Other Intervention Names

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SpyGlass cholangioscopy

Eligibility Criteria

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Inclusion Criteria

* 1\. Age 18 or older 2. Willing and able to comply with the study procedures and provide written informed consent to participate in the study 3. Recurrent biliary obstructive symptoms after biliary SEMS placement 4. Biliary SEMS occlusion.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Asian Institute of Gastroenterology, India

OTHER

Sponsor Role lead

Responsible Party

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Mohan Ramchandani

Consultant Gastroenterologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mohan Ramchandani, MD DM

Role: PRINCIPAL_INVESTIGATOR

Asian Institute of Gastroenterology

Locations

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Asian Institute of Gastroenterology

Hyderabad, Telangana, India

Site Status RECRUITING

Countries

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India

Central Contacts

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Mohan Ramchandani, MD DM

Role: CONTACT

Phone: 9701335444

Email: [email protected]

Facility Contacts

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Mohan Ramchandani, MD DM

Role: primary

Other Identifiers

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AIG-001

Identifier Type: -

Identifier Source: org_study_id