STALL vs Sole Local Wound Infiltration in Laparoscopic Cholecystectomy

NCT ID: NCT06123117

Last Updated: 2025-09-11

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

NA

Total Enrollment

850 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-16

Study Completion Date

2027-10-31

Brief Summary

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This trial is a prospective randomized superiority trial comparing sole ropivacaine based local trocar site infiltration to local infiltration combined with laparoscopic ropivacaine TAP block (STALL) in LCC.

There are only a few randomized trials comparing sole local anesthesia to additional laparoscopic TAP block in laparoscopic cholecystectomy and they have yet failed to show evidence in favor of TAP block.

We hypothesize STALL (Single Transversus Abdominis Laparoscopy-guided plane block combined with Local trocar site ropivacaine infiltration) is superior to local port site infiltration, provided that the sample size is sufficiently big.

The aim of this randomized study is to compare the efficacy of sole local anesthesia of trocar sites to STALL in LCC.

Detailed Description

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Conditions

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Cholelithiasis Cholecystitis Gallbladder Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients are analyzed following the intention to treat in three subgroups:

1. Patients treated in "day-care" outpatient surgical unit (DS): TAP+local vs local.
2. Patients treated electively in the inpatient surgery unit (IS): TAP+local vs local.
3. Emergency surgery patients (ES): TAP+local vs local.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
The study will be blinded to patients and recovery room personnel, as well as the ward nurses and physicians, but not to operating surgeon(s), anesthesiologist(s), and nurses, treating patients during the surgery.

Study Groups

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Daycare: STALL

Local ropivacaine infiltration + laparoscopically controlled TAP (transversus abdominis plane block). Daycare patients.

Group Type EXPERIMENTAL

single transversus abdominis laparoscopy-guided plane block

Intervention Type PROCEDURE

please see arm/group descriptions

local trocar site ropivacaine infiltration

Intervention Type PROCEDURE

please see arm/group descriptions

Daycare: local only

Local ropivacaine infiltration only. Daycare patients.

Group Type ACTIVE_COMPARATOR

local trocar site ropivacaine infiltration

Intervention Type PROCEDURE

please see arm/group descriptions

In-patient: STALL

Local ropivacaine infiltration + laparoscopically controlled TAP. In-patient surgery.

Group Type EXPERIMENTAL

single transversus abdominis laparoscopy-guided plane block

Intervention Type PROCEDURE

please see arm/group descriptions

local trocar site ropivacaine infiltration

Intervention Type PROCEDURE

please see arm/group descriptions

In-patient: local only

Local ropivacaine infiltration only. In-patient surgery.

Group Type ACTIVE_COMPARATOR

local trocar site ropivacaine infiltration

Intervention Type PROCEDURE

please see arm/group descriptions

Emergency: STALL

Local ropivacaine infiltration + laparoscopically controlled TAP. Emergency patients.

Group Type EXPERIMENTAL

single transversus abdominis laparoscopy-guided plane block

Intervention Type PROCEDURE

please see arm/group descriptions

local trocar site ropivacaine infiltration

Intervention Type PROCEDURE

please see arm/group descriptions

Emergency: local only

Local ropivacaine infiltration only. Emergency patients.

Group Type ACTIVE_COMPARATOR

local trocar site ropivacaine infiltration

Intervention Type PROCEDURE

please see arm/group descriptions

Interventions

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single transversus abdominis laparoscopy-guided plane block

please see arm/group descriptions

Intervention Type PROCEDURE

local trocar site ropivacaine infiltration

please see arm/group descriptions

Intervention Type PROCEDURE

Other Intervention Names

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STALL

Eligibility Criteria

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Inclusion Criteria

* All patients scheduled for elective or emergency LCC, aged over 18 and able to give an informed consent.

Exclusion Criteria

* Age under 18 years, chronic daily opioid and/or pain tolerance / pain threshold -modifying medication use (abuse), pregnancy, known allergy to local anesthetics, diagnosed severe coagulopathy and incapability to give informed consent for whatever reason.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Helsinki University Central Hospital

OTHER

Sponsor Role lead

Responsible Party

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Roman Kornosev

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Henna Sammalkorpi, MD, PhD

Role: STUDY_DIRECTOR

Helsinki UCH

Hanna Lampela, MD, PhD

Role: STUDY_DIRECTOR

Helsinki UCH

Jukka Harju, MD, PhD, Doc

Role: STUDY_DIRECTOR

Helsinki UCH

Locations

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Jorvi hospital / HUS

Espoo, Uusimaa, Finland

Site Status RECRUITING

Countries

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Finland

Central Contacts

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Roman Kornõšev, MD

Role: CONTACT

+358 504 279755

Alexey Schramko, MD, PhD, Doc

Role: CONTACT

+358 504 270610

Facility Contacts

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Roman Kornõšev

Role: primary

+358504279755

Alexey Schramko, PhD, Doc

Role: backup

+358504270610

References

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Siriwardana RC, Kumarage SK, Gunathilake BM, Thilakarathne SB, Wijesinghe JS. Local infiltration versus laparoscopic-guided transverse abdominis plane block in laparoscopic cholecystectomy: double-blinded randomized control trial. Surg Endosc. 2019 Jan;33(1):179-183. doi: 10.1007/s00464-018-6291-0. Epub 2018 Jun 25.

Reference Type BACKGROUND
PMID: 29943054 (View on PubMed)

Bumblyte V, Rasilainen SK, Ehrlich A, Scheinin T, Kontinen VK, Sevon A, Vaaraniemi H, Schramko AA. Purely ropivacaine-based TEA vs single TAP block in pain management after elective laparoscopic colon surgery within an upgraded institutional ERAS program. Surg Endosc. 2022 May;36(5):3323-3331. doi: 10.1007/s00464-021-08647-z. Epub 2021 Sep 3.

Reference Type BACKGROUND
PMID: 34480217 (View on PubMed)

Ruiz-Tovar J, Garcia A, Ferrigni C, Gonzalez J, Levano-Linares C, Jimenez-Fuertes M, Llavero C, Duran M. Laparoscopic-Guided Transversus Abdominis Plane (TAP) Block as Part of Multimodal Analgesia in Laparoscopic Roux-en-Y Gastric Bypass Within an Enhanced Recovery After Surgery (ERAS) Program: a Prospective Randomized Clinical Trial. Obes Surg. 2018 Nov;28(11):3374-3379. doi: 10.1007/s11695-018-3376-8.

Reference Type BACKGROUND
PMID: 29980989 (View on PubMed)

Peng K, Ji FH, Liu HY, Wu SR. Ultrasound-Guided Transversus Abdominis Plane Block for Analgesia in Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis. Med Princ Pract. 2016;25(3):237-46. doi: 10.1159/000444688. Epub 2016 Feb 16.

Reference Type BACKGROUND
PMID: 26885872 (View on PubMed)

Breazu CM, Ciobanu L, Hadade A, Bartos A, Mitre C, Mircea PA, Ionescu D. The efficacy of oblique subcostal transversus abdominis plane block in laparoscopic cholecystectomy - a prospective, placebo controlled study. Rom J Anaesth Intensive Care. 2016 Apr;23(1):12-18. doi: 10.21454/rjaic.7518.231.obq.

Reference Type BACKGROUND
PMID: 28913472 (View on PubMed)

Loizides S, Gurusamy KS, Nagendran M, Rossi M, Guerrini GP, Davidson BR. Wound infiltration with local anaesthetic agents for laparoscopic cholecystectomy. Cochrane Database Syst Rev. 2014 Mar 12;2014(3):CD007049. doi: 10.1002/14651858.CD007049.pub2.

Reference Type BACKGROUND
PMID: 24619479 (View on PubMed)

Elamin G, Waters PS, Hamid H, O'Keeffe HM, Waldron RM, Duggan M, Khan W, Barry MK, Khan IZ. Efficacy of a Laparoscopically Delivered Transversus Abdominis Plane Block Technique during Elective Laparoscopic Cholecystectomy: A Prospective, Double-Blind Randomized Trial. J Am Coll Surg. 2015 Aug;221(2):335-44. doi: 10.1016/j.jamcollsurg.2015.03.030. Epub 2015 Mar 27.

Reference Type BACKGROUND
PMID: 25899736 (View on PubMed)

Tolchard S, Davies R, Martindale S. Efficacy of the subcostal transversus abdominis plane block in laparoscopic cholecystectomy: Comparison with conventional port-site infiltration. J Anaesthesiol Clin Pharmacol. 2012 Jul;28(3):339-43. doi: 10.4103/0970-9185.98331.

Reference Type BACKGROUND
PMID: 22869941 (View on PubMed)

Ortiz J, Suliburk JW, Wu K, Bailard NS, Mason C, Minard CG, Palvadi RR. Bilateral transversus abdominis plane block does not decrease postoperative pain after laparoscopic cholecystectomy when compared with local anesthetic infiltration of trocar insertion sites. Reg Anesth Pain Med. 2012 Mar-Apr;37(2):188-92. doi: 10.1097/AAP.0b013e318244851b.

Reference Type BACKGROUND
PMID: 22330261 (View on PubMed)

Bava EP, Ramachandran R, Rewari V, Chandralekha, Bansal VK, Trikha A. Analgesic efficacy of ultrasound guided transversus abdominis plane block versus local anesthetic infiltration in adult patients undergoing single incision laparoscopic cholecystectomy: A randomized controlled trial. Anesth Essays Res. 2016 Sep-Dec;10(3):561-567. doi: 10.4103/0259-1162.186620.

Reference Type BACKGROUND
PMID: 27746552 (View on PubMed)

Ravichandran NT, Sistla SC, Kundra P, Ali SM, Dhanapal B, Galidevara I. Laparoscopic-assisted Tranversus Abdominis Plane (TAP) Block Versus Ultrasonography-guided Transversus Abdominis Plane Block in Postlaparoscopic Cholecystectomy Pain Relief: Randomized Controlled Trial. Surg Laparosc Endosc Percutan Tech. 2017 Aug;27(4):228-232. doi: 10.1097/SLE.0000000000000405.

Reference Type BACKGROUND
PMID: 28472015 (View on PubMed)

Peng W, Huang S, Zhou S, Yang N, Zuo M. Case report: life-threatening coronary artery spasm under transversus abdominis plane block in combination with general anesthesia. BMC Anesthesiol. 2018 Oct 20;18(1):148. doi: 10.1186/s12871-018-0616-3.

Reference Type BACKGROUND
PMID: 30342470 (View on PubMed)

Salaria ON, Kannan M, Kerner B, Goldman H. A Rare Complication of a TAP Block Performed after Caesarean Delivery. Case Rep Anesthesiol. 2017;2017:1072576. doi: 10.1155/2017/1072576. Epub 2017 Oct 29.

Reference Type BACKGROUND
PMID: 29214081 (View on PubMed)

Other Identifiers

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7351

Identifier Type: -

Identifier Source: org_study_id

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