Use of Indocyanine Green in Acute Cholecystitis

NCT ID: NCT05709548

Last Updated: 2023-09-29

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

440 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-15

Study Completion Date

2025-12-31

Brief Summary

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Laparoscopic cholecystectomy is one of the most common gastrointestinal surgeries. However, it can be technically complex in those patients diagnosed with acute cholecystitis who present severe inflammation or fibrosis, with bile duct injury being one of its main complications. The use of fluorescence cholangiography through the use of indocyanine green allows the identification of extrahepatic biliary structures, facilitating dissection and reducing the risk of bile duct lesions. Better visualization of the bile duct allows reducing the conversion rate to open surgery, as well as operating time.

The main objective is to assess a decrease in operating time in acute cholecystitis undergoing emergency surgery, to which indocyanine green is administered preoperatively.

Randomized, prospective, controlled, multicenter clinical trial of two groups of patients diagnosed with acute cholecystitis and requiring urgent cholecystectomy. The control group includes 220 patients who undergo urgent laparoscopic cholecystectomy according to the usual technique without the administration of indocyanine green, and the intervention group includes 220 patients who undergo urgent laparoscopic cholecystectomy for acute cholecystitis with the administration of indocyanine green preoperatively.

Study led by the Parc Taulí University Hospital in Sabadell.

Detailed Description

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Prospective, controlled, randomized and multicenter clinical trial comparing conventional laparoscopic cholecystectomy versus laparoscopic cholecystectomy with preoperative indocyanine green administration in patients with an indication for urgent cholecystectomy due to acute cholecystitis (of any etiology), at the Parc Taulí University Hospital and at the Germans Trias i Pujol University Hospital.

Parallel group randomization (1:1) will be performed by opening sealed envelopes, with random assignment between the two groups (intervention and control). The same number of envelopes will be assigned to the study and control group, all of them sealed and placed at random.

A four-port laparoscopic cholecystectomy will be performed by a team of surgeons with extensive experience in emergency and/or hepatobiliopancreatic surgery, according to standard techniques and safety measures.

Randomization will be carried out at the time of the indication for surgery, after acceptance and signing of the informed consent once all the inclusion criteria are met.

Conditions

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Acute Cholecystitis Bile Duct Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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control group

patients who undergo urgent laparoscopic cholecystectomy according to the usual technique without the administration of indocyanine green

Group Type NO_INTERVENTION

No interventions assigned to this group

intervention group

Patients who undergo urgent laparoscopic cholecystectomy for acute cholecystitis with the administration of indocyanine green preoperatively.

Group Type ACTIVE_COMPARATOR

Indocyanine green

Intervention Type DRUG

Subjects with a diagnosis of acute cholecystitis who undergo urgent laparoscopic cholecystectomy with the preoperative administration of indocyanine green (between 1-2 hours prior to surgery).

Interventions

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Indocyanine green

Subjects with a diagnosis of acute cholecystitis who undergo urgent laparoscopic cholecystectomy with the preoperative administration of indocyanine green (between 1-2 hours prior to surgery).

Intervention Type DRUG

Other Intervention Names

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indocyanine green group

Eligibility Criteria

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Inclusion Criteria

* Patients with an indication for urgent laparoscopic cholecystectomy due to acute cholecystitis regardless of its etiology.
* Age over 18 years.
* Patients who have read the study information sheet and signed the informed consent sheet.

Exclusion Criteria

* Pregnant or breastfeeding patients.
* Grade IV renal failure or patients on dialysis
* Patients with previous hypersensitivity to indocyanine green
* Patients with allergy to iodinated contrast
* Patients with clinical hyperthyroidism, autonomic thyroid adenomas, and focal and diffuse autonomic abnormalities of the thyroid gland
* Contraindication to laparoscopic surgery.
* Suspicion of choledocholithiasis
* Pediatric patients under 18 years of age.
* Patients who refused to participate in the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Corporacion Parc Tauli

OTHER

Sponsor Role lead

Responsible Party

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Anna Muñoz - Campaña

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Anna Muñoz Campaña, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Universitari Parc Taulí

Enrico Marrano

Role: PRINCIPAL_INVESTIGATOR

Germans Trias i Pujol Hospital

Locations

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Hospital Universitari Parc Tauli

Sabadell, Barcelona, Spain

Site Status RECRUITING

Hospital de Vic

Vic, Barcelona, Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Anna Muñoz Campaña, PhD

Role: CONTACT

003493 723 10 10 ext. 80614

Coloma Moreno

Role: CONTACT

003493 723 10 10 ext. 22219

Facility Contacts

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ANNA MUÑOZ-CAMPAÑA, PhD

Role: primary

003493 723 10 10 ext. 80614

ENRICO MARRANO

Role: backup

0034934 65 12 00

VICTORIA LUCAS GUERRERO, Dr

Role: primary

References

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Pesce A, Piccolo G, Lecchi F, Fabbri N, Diana M, Feo CV. Fluorescent cholangiography: An up-to-date overview twelve years after the first clinical application. World J Gastroenterol. 2021 Sep 28;27(36):5989-6003. doi: 10.3748/wjg.v27.i36.5989.

Reference Type BACKGROUND
PMID: 34629815 (View on PubMed)

Di Maggio F, Hossain N, De Zanna A, Husain D, Bonomo L. Near-Infrared Fluorescence Cholangiography can be a Useful Adjunct during Emergency Cholecystectomies. Surg Innov. 2022 Aug;29(4):526-531. doi: 10.1177/1553350620958562. Epub 2020 Sep 16.

Reference Type BACKGROUND
PMID: 32936054 (View on PubMed)

Reeves JJ, Broderick RC, Lee AM, Blitzer RR, Waterman RS, Cheverie JN, Jacobsen GR, Sandler BJ, Bouvet M, Doucet J, Murphy JD, Horgan S. The price is right: Routine fluorescent cholangiography during laparoscopic cholecystectomy. Surgery. 2022 May;171(5):1168-1176. doi: 10.1016/j.surg.2021.09.027. Epub 2021 Dec 21.

Reference Type BACKGROUND
PMID: 34952715 (View on PubMed)

Dip F, LoMenzo E, Sarotto L, Phillips E, Todeschini H, Nahmod M, Alle L, Schneider S, Kaja L, Boni L, Ferraina P, Carus T, Kokudo N, Ishizawa T, Walsh M, Simpfendorfer C, Mayank R, White K, Rosenthal RJ. Randomized Trial of Near-infrared Incisionless Fluorescent Cholangiography. Ann Surg. 2019 Dec;270(6):992-999. doi: 10.1097/SLA.0000000000003178.

Reference Type BACKGROUND
PMID: 30614881 (View on PubMed)

Wang X, Teh CSC, Ishizawa T, Aoki T, Cavallucci D, Lee SY, Panganiban KM, Perini MV, Shah SR, Wang H, Xu Y, Suh KS, Kokudo N. Consensus Guidelines for the Use of Fluorescence Imaging in Hepatobiliary Surgery. Ann Surg. 2021 Jul 1;274(1):97-106. doi: 10.1097/SLA.0000000000004718.

Reference Type BACKGROUND
PMID: 33351457 (View on PubMed)

Broderick RC, Lee AM, Cheverie JN, Zhao B, Blitzer RR, Patel RJ, Soltero S, Sandler BJ, Jacobsen GR, Doucet JJ, Horgan S. Fluorescent cholangiography significantly improves patient outcomes for laparoscopic cholecystectomy. Surg Endosc. 2021 Oct;35(10):5729-5739. doi: 10.1007/s00464-020-08045-x. Epub 2020 Oct 14.

Reference Type BACKGROUND
PMID: 33052527 (View on PubMed)

van den Bos J, Schols RM, Luyer MD, van Dam RM, Vahrmeijer AL, Meijerink WJ, Gobardhan PD, van Dam GM, Bouvy ND, Stassen LP. Near-infrared fluorescence cholangiography assisted laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy (FALCON trial): study protocol for a multicentre randomised controlled trial. BMJ Open. 2016 Aug 26;6(8):e011668. doi: 10.1136/bmjopen-2016-011668.

Reference Type BACKGROUND
PMID: 27566635 (View on PubMed)

Pavel MC, Boira MA, Bashir Y, Memba R, Llacer E, Estalella L, Julia E, Conlon KC, Jorba R. Near infrared indocyanine green fluorescent cholangiography versus intraoperative cholangiography to improve safety in laparoscopic cholecystectomy for gallstone disease-a systematic review protocol. Syst Rev. 2022 Mar 3;11(1):36. doi: 10.1186/s13643-022-01907-6.

Reference Type BACKGROUND
PMID: 35241165 (View on PubMed)

Other Identifiers

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INDURGTRIAL2022

Identifier Type: -

Identifier Source: org_study_id

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