Impact of Biliopancreatic Limb Length on Diabetes Following Distal Gastrectomy

NCT ID: NCT04889859

Last Updated: 2023-03-14

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

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-05-01

Study Completion Date

2023-02-28

Brief Summary

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This is a prospective, randomized controlled trial to investigate the impact of a long biliopancreatic limb of Roux-en-Y reconstruction on diabetes control in patients with concurrent type 2 diabetes and gastric cancer

Detailed Description

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The present study aimed to compare the changes in glucose metabolism and incretin hormone responses following long-limb bypass Roux-en-Y reconstruction with different biliopancreatic limb lengths after distal gastrectomy in gastric cancer patients with type 2 diabetes. This is a prospective, single-center, randomized controlled trial. Patients diagnosed with stage I gastric cancer and type 2 diabetes are eligible for the present study. Patients who will undergo laparoscopic distal gastrectomy for cancer located at the lower two-thirds of the stomach will only be included.

The reconstruction method will be randomly assigned among long-Roux limb Roux-en-Y (with 100 cm-long Roux limb \& 50cm-long biliopancreatic limb) or long-biliopancreatic limb Roux-en-Y (with 50 cm-long Roux limb \& 100cm-long biliopancreatic limb) reconstruction methods.

All the patients are subjected to a 75g-oral glucose tolerance test (OGTT) preoperatively, and at 3 months, 6 months postoperatively, and serum glucose, as well as incretin hormones, will be serially measured. Fecal samples will be obtained preoperatively and at 3 months after surgery for gut microbiota analyses.

Conditions

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Stomach Neoplasm Diabetes Mellitus, Type 2

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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long RL group

long Roux limb Roux-en-Y reconstruction

Group Type ACTIVE_COMPARATOR

long Roux limb Roux-en-Y reconstruction

Intervention Type PROCEDURE

After standard laparoscopic distal gastrectomy with radical lymphadenectomy, the gastrointestinal continuity will be restored with Roux-en-Y reconstruction using 100 cm-long Roux limb and 50 cm-long biliopancreatic limb.

long BPL group

long biliopancreatic limb Roux-en-Y reconstruction

Group Type EXPERIMENTAL

long biliopancreatic limb Roux-en-Y reconstruction

Intervention Type PROCEDURE

After standard laparoscopic distal gastrectomy with radical lymphadenectomy, the gastrointestinal continuity will be restored with Roux-en-Y reconstruction using 50 cm-long Roux limb and 100 cm-long biliopancreatic limb.

Interventions

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long Roux limb Roux-en-Y reconstruction

After standard laparoscopic distal gastrectomy with radical lymphadenectomy, the gastrointestinal continuity will be restored with Roux-en-Y reconstruction using 100 cm-long Roux limb and 50 cm-long biliopancreatic limb.

Intervention Type PROCEDURE

long biliopancreatic limb Roux-en-Y reconstruction

After standard laparoscopic distal gastrectomy with radical lymphadenectomy, the gastrointestinal continuity will be restored with Roux-en-Y reconstruction using 50 cm-long Roux limb and 100 cm-long biliopancreatic limb.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients diagnosed with type 2 diabetes as well as pathologically proven gastric cancer of clinical stage I according to the AJCC 8th edition
* Those who are expected to undergo laparoscopic distal gastrectomy

Exclusion Criteria

1. baseline fasting C-peptide level \< 1.0 ng/dL (who had the possibility of type 1 diabetes)
2. previous radiotherapy or surgery at upper abdomen other than laparoscopic cholecystectomy
3. other malignancies in recent 5 years
4. vulnerable patients (pregnant women, those with cognitive impairment, etc)
5. ECOG-PS ≥ 2
6. participating in other clinical trials within 6 months
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kyungpook National University Chilgok Hospital

OTHER

Sponsor Role lead

Responsible Party

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Ji Yeon Park

Ji Yeon Park

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ji Yeon Park, MD

Role: PRINCIPAL_INVESTIGATOR

Kyungpook National University Chilgok Hospital

Locations

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Kyungpook National University Chilgok Hospital

Daegu, , South Korea

Site Status

Countries

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South Korea

Other Identifiers

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KNUCH 2019-04-004

Identifier Type: -

Identifier Source: org_study_id

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