Indocyanine Green to Visualize Critical View of Safety During Laparoscopic Cholecystectomy for Acute Cholecystitis

NCT ID: NCT04624841

Last Updated: 2020-12-16

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

PHASE4

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-01

Study Completion Date

2022-01-15

Brief Summary

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The purpose of this prospective randomized trial is to study the role of Indocyanine green (ICG) to visualize the Critical View of Safety during emergency Laparoscopic Cholecystectomy for patients with Acute Cholecystitis.

Detailed Description

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After informing about the study and obtaining consent to participate, patients who are diagnosed with Acute Cholecystitis and posted for emergency Laparoscopic Cholecystectomy will be randomly assigned to receive either ICG or not as a method to identify the Critical View of Safety during the operation.

The primary outcome is whether there was a precise and satisfactory visualization of the junction between the cystic duct, the common hepatic duct, and the common bile duct by indocyanine green compared to the control group. The time taken to achieve this will be measured in minutes from video recordings of the laparoscopic surgery. The process will be further assessed by a surgeons' satisfaction score.

The expected duration of the study will be 12 months involving a total of 80 patients randomized into two groups- 40 patients in the intervention group and 40 patients in the control group.

The expected outcome of the study is that ICG is more effective than the control group in providing precise and satisfactory visualization of Critical View of Safety and takes less time. We predict the surgeons to be equally or more satisfied with ICG compared to control.

Conditions

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Acute Cholecystitis Acute; Cholecystitis, Choledocholithiasis Acute Cholecystitis With Obstruction

Keywords

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acute cholecystitis laparoscopic cholecystectomy critical view of safety safe cholecystectomy indocyanine green operative cholangiogram fluorescent imaging near-infrared imaging

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective randomized controlled trial
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
The patient is blinded to the intervention S/he receives. The surgeon, investigator, and outcomes assessor are masked but not strictly blinded up to the point when the near-infrared camera is switched on

Study Groups

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ICG group

Participants receive an intravenous injection of 0.05 mg/kg of ICG 45 minutes preoperatively.

A Pinpoint Endoscopic Fluorescence System (Novadac Technologies Inc., Canada) for ICG Fluorescence Observation with the easy switchable white light-fluorescent mode is used.

Before dividing any tubular structure, the fluorescence imaging mode is routinely used again, and fluorescent angiography is performed by re-injecting the same dose of ICG as initially used.

After the division of the cystic duct and artery, the fluorescence imaging mode is applied again to check for bile leakage.

Group Type EXPERIMENTAL

Indocyanine Green

Intervention Type DRUG

2.5-7.5 mg (0.05 mg/kg) injection

No ICG Group

No ICG is administered after randomization of the patient to a control group and hence will not produce any enhancement of the image on A Pinpoint Endoscopic Fluorescence System for ICG Fluorescence Observation. This will continue as a routine Laparoscopic cholecystectomy without fluorescent imaging enhancement.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Indocyanine Green

2.5-7.5 mg (0.05 mg/kg) injection

Intervention Type DRUG

Other Intervention Names

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ICG fluorescent Imaging

Eligibility Criteria

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Inclusion Criteria

* Patient scheduled for emergency Laparoscopic Cholecystectomy for Acute Cholecystitis
* Patient age ≥ 18 years.
* Patients who consent to take part in the study

Exclusion Criteria

* Preoperative planned for Open Cholecystectomy
* Allergy towards iodine, iohexol or ICG
* Pregnancy or lactation
* Renal insufficiency
* Legally incompetent for any reason
* Withdrawal of inclusion consent at any time
* Prisoners
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hamad Medical Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Dr Zia Ahmed Aftab, MBBS,FRCS,FACS

Consultant in Acute Care Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Zia Aftab, MBBS, FACS

Role: PRINCIPAL_INVESTIGATOR

Hamad Medical Corporation

Locations

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Hamad General Hospital

Doha, , Qatar

Site Status

Countries

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Qatar

Central Contacts

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Zia Aftab, MBBS, FACS

Role: CONTACT

Phone: 00974-66233904

Email: [email protected]

Shameel Musthafa, MBBS, FACS

Role: CONTACT

Phone: 00974-77274577

Email: [email protected]

Facility Contacts

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Zia Aftab

Role: primary

References

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Ishizawa T, Bandai Y, Kokudo N. Fluorescent cholangiography using indocyanine green for laparoscopic cholecystectomy: an initial experience. Arch Surg. 2009 Apr;144(4):381-2. doi: 10.1001/archsurg.2009.9. No abstract available.

Reference Type BACKGROUND
PMID: 19380655 (View on PubMed)

Daskalaki D, Fernandes E, Wang X, Bianco FM, Elli EF, Ayloo S, Masrur M, Milone L, Giulianotti PC. Indocyanine green (ICG) fluorescent cholangiography during robotic cholecystectomy: results of 184 consecutive cases in a single institution. Surg Innov. 2014 Dec;21(6):615-21. doi: 10.1177/1553350614524839. Epub 2014 Mar 9.

Reference Type BACKGROUND
PMID: 24616013 (View on PubMed)

Dip F, Roy M, Lo Menzo E, Simpfendorfer C, Szomstein S, Rosenthal RJ. Routine use of fluorescent incisionless cholangiography as a new imaging modality during laparoscopic cholecystectomy. Surg Endosc. 2015 Jun;29(6):1621-6. doi: 10.1007/s00464-014-3853-7. Epub 2014 Oct 3.

Reference Type BACKGROUND
PMID: 25277476 (View on PubMed)

Pesce A, Piccolo G, La Greca G, Puleo S. Utility of fluorescent cholangiography during laparoscopic cholecystectomy: A systematic review. World J Gastroenterol. 2015 Jul 7;21(25):7877-83. doi: 10.3748/wjg.v21.i25.7877.

Reference Type BACKGROUND
PMID: 26167088 (View on PubMed)

Overby DW, Apelgren KN, Richardson W, Fanelli R; Society of American Gastrointestinal and Endoscopic Surgeons. SAGES guidelines for the clinical application of laparoscopic biliary tract surgery. Surg Endosc. 2010 Oct;24(10):2368-86. doi: 10.1007/s00464-010-1268-7. Epub 2010 Aug 13. No abstract available.

Reference Type BACKGROUND
PMID: 20706739 (View on PubMed)

Other Identifiers

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U1111-1256-1361

Identifier Type: OTHER

Identifier Source: secondary_id

IRGC-05-NI-18-362

Identifier Type: -

Identifier Source: org_study_id