Hemopatch as a Tool to Prevent Biliary Fistula in Liver Surgery.

NCT ID: NCT03993067

Last Updated: 2021-04-06

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

220 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-15

Study Completion Date

2020-01-15

Brief Summary

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The aim of the study is to investigate the use of Hemopatch to prevent biliary fistula in patients submitted to surgery for malignancy.

Detailed Description

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Background: Biliary fistula (BF) is one of the most common sources of post hepatectomy morbidity. International Study Group of Liver Surgery (ISGLS) define BF as increased bilirubin concentration in the drain at least 3 times greater than the serum bilirubin concentration on or after postoperative day (POD) 3. BF is graded into grade A, B and C, based on the clinical impact on the postoperative course. Considering ISGLS definition, the incidence of BF ranges from 4,4% to 27,2%. The definition developed in Humanitas Research Hospital (HRH), defines BF as bilirubin concentration in the drain fluid greater than 10 mg/dL on or after POD 3. In this case, the incidence is around 8%. Various topical haemostatic agents have been developed for liver resection area management their usefulness in preventing BF by using a sealing product on the resection surface still remains unclear and needs to be assessed.

Objective: this study aimed to assess the clinical validation of Hemopatch to prevent post-operative biliary fistula. Secondarily, it is aimed to evaluate the clinical validity of the two proposed definition of biliary fistula.

Methods: According to the incidence of BF in our previous series (considering ISGLS definition), we designed a randomized controlled study on 220 patients, who underwent hepatic resection from 2018 to 2020. Patients were randomized to treatment group A (Hemopatch) and standard group B (Tisseal and Tabotamp). Both ISGLS and HRH definitions of BF were considered. All patients were systematically drained. Drains were maintained at least 5 days, and bilirubin was measured on PODs 3, 5, and 7. Drains were removed if the bilirubin concentration in the drain fluid was less than 10 mg/dL on POD 7. A statistical analysis to compare perioperative variables between two groups was performed. Then, a multivariate analysis was performed to identify potential risk factors for BF.

Conditions

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Biliary Fistula Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants

Study Groups

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Standard Treatment

Fibrin glue and Tabotamp on cut surface

Group Type ACTIVE_COMPARATOR

Fribrin glue and Tabotamp

Intervention Type PROCEDURE

Fibrin glue and Tabotampis the standard treatment

Hemopatch

Hemopatch on cut surface

Group Type EXPERIMENTAL

Hemopatch

Intervention Type PROCEDURE

Hemopatch is a collagen based sealant is a hemostat agent. We want to investigate his role in the prevention of post operative biliary fistula

Interventions

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Hemopatch

Hemopatch is a collagen based sealant is a hemostat agent. We want to investigate his role in the prevention of post operative biliary fistula

Intervention Type PROCEDURE

Fribrin glue and Tabotamp

Fibrin glue and Tabotampis the standard treatment

Intervention Type PROCEDURE

Other Intervention Names

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Experimental Standard treatment

Eligibility Criteria

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Inclusion Criteria

* all patients submitted to liver surgery for malignancies.
* \>18 years of age.

Exclusion Criteria

* biliary reconstruction
* other associated visceral resections
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Milan

OTHER

Sponsor Role lead

Responsible Party

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Prof. Guido Torzilli

Director of the Department of Surgery Head of the General and Hepatobiliary surgery unit, Clinical Professor and Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Guido Torzilli

Role: PRINCIPAL_INVESTIGATOR

Department of Biomedical Sciences Humanitas University, Milan

Locations

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Department of Hepatobiliary and General Surgery, Humanitas Research Hospital, University of Milan

Rozzano, Milan, Italy

Site Status

Countries

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Italy

Other Identifiers

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HBF2018

Identifier Type: -

Identifier Source: org_study_id

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