Early Versus Delayed Double-guidewire Technique in Difficult Biliary Cannulation. (DFG)

NCT ID: NCT03582540

Last Updated: 2019-09-23

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

COMPLETED

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-11-02

Study Completion Date

2019-08-30

Brief Summary

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This is a prospective randomized comparative multicentric study. Briefly, we will analyze the technical success, performance and clinical outcomes of early versus delayed double-guidewire technique (DGT) in difficult biliary cannulation.

Detailed Description

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This is a prospective study performed in 20 tertiary medical centers in France. We aim to recruit 150 patients from 2016 to 2020. Patients with a native papilla scheduled for ERCP (endoscopic retrograde cholangiopancreatography) are screened for the study. Patients with a difficult biliary cannulation are included in the study if the guidewire is inserted in the pancreatic duct. At that point, patients are randomized in two arms: early versus delayed DGT. The early arm attempts biliary cannulation using the double-guidewire technique immediately and the delayed arm uses the double-guidewire technique only if 10 more minutes of standard cannulation technique does not allow biliary cannulation. The primary outcome is the biliary cannulation rate success. Secondary outcomes are complications rate and performance of the technique in both arms. Follow-up is 30 days.

Conditions

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Catheterization Cholangiopancreatography Endoscopic Retrograde Cholangiography Biliary Cannulation Difficult Biliary Cannulation Double-guidewire Technique

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients with a difficult biliary cannulation are included in the study if the guidewire is inserted in the pancreatic duct. At that point, patients are randomized in two arms: early versus delayed DGT. The early arm attempts biliary cannulation using the DGT immediately and the delayed arm uses the DGT only if 10 more minutes of conventional cannulation technique does not allow biliary cannulation.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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early double-guidewire technique (DGT)

First arm: early double-guidewire technique The early arm attempts biliary cannulation using the DGT immediately once the guidewire is inserted in the pancreatic duct in cases of difficult biliary cannulation.

Group Type ACTIVE_COMPARATOR

Double-guidewire cannulation technique

Intervention Type PROCEDURE

With the DGT, a guidewire is first inserted deep into the PD. The cannulation device is then withdrawn, reloaded with a second guidewire, and reinserted through the working channel of the endoscope to cannulate the common bile duct.

delayed double-guidewire technique (DGT)

In the delayed arm, once the guidewire is inserted in the pancreatic duct, the operator continues to attempt biliary cannulation with conventional technique (contrast- or guidewire-assisted). DGT is used only if 10 more minutes of conventional cannulation technique does not allow biliary access.

Group Type ACTIVE_COMPARATOR

Double-guidewire cannulation technique

Intervention Type PROCEDURE

With the DGT, a guidewire is first inserted deep into the PD. The cannulation device is then withdrawn, reloaded with a second guidewire, and reinserted through the working channel of the endoscope to cannulate the common bile duct.

Interventions

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Double-guidewire cannulation technique

With the DGT, a guidewire is first inserted deep into the PD. The cannulation device is then withdrawn, reloaded with a second guidewire, and reinserted through the working channel of the endoscope to cannulate the common bile duct.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients 18 years old and more
* Native papilla
* Clinical indications of ERCP
* Difficult biliary cannulation defined by unintentional guidewire insertion into the pancreatic duct before biliary cannulation is successful
* Informed consent completed by the patient

Exclusion Criteria

* Contraindication to upper gastrointestinal endoscopy
* ERCP with direct biliary cannulation success
* ERCP with inability to cannulate the bile duct nor the pancreatic duct
* Coagulation or hemostasis disorder (TP \< 60%, TCA\> 40 sec. et plaquettes \< 60000/mm3).
* Patient under active antiaggregant or anticoagulant medication other than aspirin
* Endoscopic treatment of chronic pancreatitis
* Pregnancy or breastfeeding
* ERCP performed by another operator than an investigator
* Patient's voluntary withdrawal
* Withdrawal decision by the investigator or sponsor
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Société Française d'Endoscopie Digestive

OTHER

Sponsor Role lead

Responsible Party

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Dr Arthur Laquiere

Gastroenterologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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ARTHUR LAQUIERE, MD

Role: PRINCIPAL_INVESTIGATOR

Société Française d'Endoscopie Digestive

Locations

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Clinique de Bercy

Charenton-le-Pont, , France

Site Status

Hôpital Dupuytren

Limoges, , France

Site Status

Hopital Saint Joseph

Marseille, , France

Site Status

Groupe Hospitalier Diaconesses - La Croix Saint-Simon

Paris, , France

Site Status

Hôpital Haut Lévêque

Pessac, , France

Site Status

Centre Hospitalier Lyon Sud

Pierre-Bénite, , France

Site Status

Centre Hospitalier de Bigorre

Tarbes, , France

Site Status

Centre Hospitalier de Vichy

Vichy, , France

Site Status

Countries

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France

References

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Other Identifiers

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ID RCB: 2016-A01016-45

Identifier Type: -

Identifier Source: org_study_id

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