Endoscopic Retrograde Cholangiopancreatography In Patients Older Than 65Years Old With Obstructive Jaundice: Efficacy And Outcome

NCT ID: NCT06093048

Last Updated: 2023-10-31

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

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-30

Study Completion Date

2024-10-31

Brief Summary

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The incidence of pancreato-biliary disorders ,including malignancy, is increasing in elderly patients. Endoscopic retrograde cholangiopancreatography (ERCP) is a well-known therapeutic tool for these pancreato-biliary disorders.

In general, old age is defined as being more than 65 years of age by the World Health Organization. The increase in the domestic aged population is related to the increasing demand for therapeutic ERCP in elderly patients with pancreato-biliary disorders. Common bile duct stones and cancer account for70 % of all jaundice cases in patients over the age of 65 years . This is related to increasing prevalences of cholelithiasis, choledocholithiasis, and malignancy with advancing age .

Endoscopic Retrograde Cholangiopancreatography(ERCP) represents the gold standard technique for the treatment of biliary or pancreatic tract pathology, and it could be often performed with therapeutic intent by realizing procedures such as insertion of bile duct stents and/or endoscopic sphincterotomy. However, evidence about its safety in the elderly is still controversial.

Detailed Description

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However, therapeutic ERCP is an invasive procedure and is associated with several complications, such as bleeding, pancreatitis, cholangitis, perforation, and mortality. A higher incidence of periprocedural complications might be expected in elderly patients because of the high prevalence of concomitant medical disorders, such as cardiopulmonary and cerebrovascular diseases, and the poor general condition of this population \[8\].

Despite many previous reports of the safety and efficacy of ERCP in elderly patients, in real clinical practice, there is concern regarding complications of ERCP performed in patients more than 65years old. Also comparative reports of the efficacy and safety of therapeutic ERCP, especially inpatients over 65 years of age, are limited. To investigate this issue, we will evaluate the clinical outcomes such as the technical success rate, procedure-related complications rate, and anesthesia-related adverse events rate of therapeutic ERCP in a older aged group (over than 65 years of age) and control group (less than 65 years of age) at a single tertiary center.

Aim of the work This study aims to evaluate the outcome and safety of ERCP in patients with obstructive jaundice over than 65 years of age.

Conditions

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Obstructive Jaundice

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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group A

patients with obstructive jaundice equal or older than 65 years old

Group Type ACTIVE_COMPARATOR

Endoscopic retrograde cholangiopancreatography

Intervention Type PROCEDURE

saftey and outcome in patients older than 65 years old

group B

patients with obstructive jaundice younger than 65 years old

Group Type ACTIVE_COMPARATOR

Endoscopic retrograde cholangiopancreatography

Intervention Type PROCEDURE

saftey and outcome in patients older than 65 years old

Interventions

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Endoscopic retrograde cholangiopancreatography

saftey and outcome in patients older than 65 years old

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* patients with obstructive jaundice older than 18 years old

Exclusion Criteria

* patients who refuse consent
* patients under 18 years old
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sohag University

OTHER

Sponsor Role lead

Responsible Party

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Mohamed Ezzat Mahmoud

specialist of internal medicine sohag university hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mohamed E Mahmoud, Specialist

Role: STUDY_DIRECTOR

Sohag University

Mohamed E Mahmoud

Role: STUDY_DIRECTOR

Sohag University

Locations

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Sohag university Hospital

Sohag, , Egypt

Site Status

Countries

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Egypt

Central Contacts

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mohamed E mahmoud, spcialist

Role: CONTACT

01280711516

Hassan A Hassanein, professor

Role: CONTACT

01003459741

Facility Contacts

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Magdy M Amin, professor

Role: primary

References

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Zhang ZM, Liu Z, Liu LM, Zhang C, Yu HW, Wan BJ, Deng H, Zhu MW, Liu ZX, Wei WP, Song MM, Zhao Y. Therapeutic experience of 289 elderly patients with biliary diseases. World J Gastroenterol. 2017 Apr 7;23(13):2424-2434. doi: 10.3748/wjg.v23.i13.2424.

Reference Type BACKGROUND
PMID: 28428722 (View on PubMed)

Ukkonen M, Siiki A, Antila A, Tyrvainen T, Sand J, Laukkarinen J. Safety and Efficacy of Acute Endoscopic Retrograde Cholangiopancreatography in the Elderly. Dig Dis Sci. 2016 Nov;61(11):3302-3308. doi: 10.1007/s10620-016-4283-2. Epub 2016 Aug 26.

Reference Type BACKGROUND
PMID: 27565508 (View on PubMed)

Perisetti A, Goyal H, Sharma N. Clinical safety and outcomes of glucagon use during endoscopic retrograde cholangiopancreatography (ERCP). Endosc Int Open. 2022 Apr 14;10(4):E558-E561. doi: 10.1055/a-1747-3242. eCollection 2022 Apr.

Reference Type BACKGROUND
PMID: 35433228 (View on PubMed)

Holt BA. Increased severity of post-endoscopic retrograde cholangiopancreatography complications in the elderly: an issue to be addressed. Dig Endosc. 2014 Jul;26(4):534-5. doi: 10.1111/den.12298. No abstract available.

Reference Type BACKGROUND
PMID: 25040209 (View on PubMed)

Other Identifiers

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Soh-Med-23-10-07MD

Identifier Type: -

Identifier Source: org_study_id

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