Sems Placement With and Without Biliary Sphincterectomy in Patients With Malignant Biliary Obstruction

NCT ID: NCT04805450

Last Updated: 2023-03-21

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

1075 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-10-01

Study Completion Date

2023-12-31

Brief Summary

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Placement of biliary self expanding metal stent (SEMS) is indicated when malignant common bile duct obstruction is encountered \[1\]. Currently, there is still controversy regarding the use of endoscopic sphincterotomy (EST) before the placement of biliary stents \[2-5\].

The aim of this prospective randomized, multicenter study is to investigate the role of EST before fully covered SEMS placement in patients with neoplastic biliary obstruction.

Detailed Description

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Conditions

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Malignant Bile Duct Obstruction

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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ES before SEMS placement

ERCP with ES before biliary fully covered SEMS placement.

Group Type ACTIVE_COMPARATOR

ES before fully covered SEMS placement

Intervention Type PROCEDURE

no ES before SEMS placement

ERCP without ES before biliary fully covered SEMS placement.

Group Type ACTIVE_COMPARATOR

no ES before fully covered SEMS placement

Intervention Type PROCEDURE

Interventions

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ES before fully covered SEMS placement

Intervention Type PROCEDURE

no ES before fully covered SEMS placement

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients referred for endoscopic retrograde cholangiopancreatography
* Malignant bile duct obstruction
* Signed written informed consent
* Age \> 18

Exclusion Criteria

* Inability to provide inform consent
* Pregnancy or lactation
* Suspected perforation of the GI tract
* Anatomical alterations due to previous surgery (Billroth surgery)
* Coagulation alterations
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Istituto Clinico Humanitas

OTHER

Sponsor Role lead

Responsible Party

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Michele Tedeschi

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Istituto Clinico Humanitas

Rozzano, Milano, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Andrea Anderloni, MD, PhD

Role: CONTACT

00390282247308

References

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Dumonceau JM, Tringali A, Blero D, Deviere J, Laugiers R, Heresbach D, Costamagna G; European Society of Gastrointestinal Endoscopy. Biliary stenting: indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy. 2012 Mar;44(3):277-98. doi: 10.1055/s-0031-1291633. Epub 2012 Feb 1.

Reference Type BACKGROUND
PMID: 22297801 (View on PubMed)

Simmons DT, Petersen BT, Gostout CJ, Levy MJ, Topazian MD, Baron TH. Risk of pancreatitis following endoscopically placed large-bore plastic biliary stents with and without biliary sphincterotomy for management of postoperative bile leaks. Surg Endosc. 2008 Jun;22(6):1459-63. doi: 10.1007/s00464-007-9643-8. Epub 2007 Nov 20.

Reference Type BACKGROUND
PMID: 18027045 (View on PubMed)

Artifon EL, Sakai P, Ishioka S, Marques SB, Lino AS, Cunha JE, Jukemura J, Cecconello I, Carrilho FJ, Opitz E, Kumar A. Endoscopic sphincterotomy before deployment of covered metal stent is associated with greater complication rate: a prospective randomized control trial. J Clin Gastroenterol. 2008 Aug;42(7):815-9. doi: 10.1097/MCG.0b013e31803dcd8a.

Reference Type BACKGROUND
PMID: 18285718 (View on PubMed)

Giorgio PD, Luca LD. Comparison of treatment outcomes between biliary plastic stent placements with and without endoscopic sphincterotomy for inoperable malignant common bile duct obstruction. World J Gastroenterol. 2004 Apr 15;10(8):1212-4. doi: 10.3748/wjg.v10.i8.1212.

Reference Type BACKGROUND
PMID: 15069728 (View on PubMed)

Cui PJ, Yao J, Zhao YJ, Han HZ, Yang J. Biliary stenting with or without sphincterotomy for malignant biliary obstruction: a meta-analysis. World J Gastroenterol. 2014 Oct 14;20(38):14033-9. doi: 10.3748/wjg.v20.i38.14033.

Reference Type BACKGROUND
PMID: 25320543 (View on PubMed)

Other Identifiers

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ES vs noES-1

Identifier Type: -

Identifier Source: org_study_id

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