Indocyanine Green Fluorescence in Evaluation of Pancreatic Remnant Perfusion.

NCT ID: NCT06198400

Last Updated: 2024-08-21

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

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-05-01

Study Completion Date

2027-07-01

Brief Summary

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Main goal of this study is to evaluate the blood flow in a post resection pancreatic remnant after pancreaticoduodenectomy with use of indocyanine green fluorescence. If the hypothesis will be proven, evaluation of perfusion of the pancreatic remnant with indocyanine green could be used to estimate the increased risk of the development of pancreatic fistula.

Detailed Description

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Pancreatoduodenectomy is associated with nearly 25% incidence of postoperative complications. One of the most severe complications is a postoperative pancreatic fistula. The exact cause of postoperative fistula development is still unknown, but it appears to be multifactorial. Proper perfusion of pancreatic remnant is essential for the healing of pancreaticojejunostomy. To date, there is no method to reliably evaluate the vascular supply of the remnant. One of the methods for assessment of organ perfusion is the indocyanine green fluorescence. This study aims to determine if indocyanine green fluorescence is a reliable method to measure the perfusion of the post-resection pancreatic remnant. Secondary outcome is to determine, if perioperative evaluation of the vascular supply of the postresection remnant may predict the increased risk of the postoperative pancreatic fistula development.

This study is designed as a prospective experimental study. All consecutive patients undergoing open pancreaticoduodenectomy at our department in the 1.5.2024-31.12.2026 period will be enrolled. Exclusion criteria are allergy to indocyanine green and refusal by the patient.The adequacy of the vascular supply of the post-resection pancreatic remnant will be perioperatively evaluated using fluorescence detector. Patients will be divided into two groups. Those with hazardous and non-hazardous vascular supply. The incidence of pancreatic fistula in both groups is to be compared. Postoperative data including morbidity, mortality, hospital stay, intensive care unit stay and postoperative fistula development will be collected.

If a perioperative assessment of the perfusion of post-resection pancreatic remnant using indocyanine green is proven to be a suitable method to estimate the increased risk of the pancreatic fistula, the list of the existing known risk factors could be expanded. In the most high-risk patients the modification of the surgical procedure could be considered.

Conditions

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Pancreatic Fistula

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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All patients undergoing the pancreaticoduodenectomy

All consecutive patients undergoing the pancreaticoduodenectomy at our institution in the 1.5.2024-31.12.2026 period will be enrolled in this study.

Group Type EXPERIMENTAL

Perioperative assessment of the perfusion of post-resection pancreatic remnant using indocyanine green-VerDye

Intervention Type DIAGNOSTIC_TEST

The adequacy of the vascular supply of the post resection pancreatic remnant after pancreatic neck division will be evaluated using ICG detector. Indocyanine green fluorescence product -Verdye™ will be intravenously applied. The application of the substance will be performed according to the current consensus statement and recommendation

Interventions

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Perioperative assessment of the perfusion of post-resection pancreatic remnant using indocyanine green-VerDye

The adequacy of the vascular supply of the post resection pancreatic remnant after pancreatic neck division will be evaluated using ICG detector. Indocyanine green fluorescence product -Verdye™ will be intravenously applied. The application of the substance will be performed according to the current consensus statement and recommendation

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* All consecutive patients undergoing open pancreaticoduodenectomy at our department in the selected period

Exclusion Criteria

* Allergy to indocyanine green
* Refusal by the patient
* Mini-invasive procedure.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Charles University, Czech Republic

OTHER

Sponsor Role lead

Responsible Party

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Štěpán-Ota Schütz

Surgical resident, Postgraduate student

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Radek Pohnán

Role: STUDY_DIRECTOR

Department of Surgery, Second Faculty of Medicine of Charles University and Military University Hospital Prague, Czech Republic

Locations

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Department of Surgery, Second Faculty of Medicine of Charles University and Military University Hospital Prague, Czech Republic

Prague, Czech Republic, Czechia

Site Status RECRUITING

Countries

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Czechia

Central Contacts

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Štěpán-Ota Schutz

Role: CONTACT

+420 7332 24 640

Michael Rousek

Role: CONTACT

+420 973 202 903

Facility Contacts

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Štěpán-Ota Schütz, MD

Role: primary

+420 7332 24 640

Michael Rousek, MD

Role: backup

+420 973 202 903

References

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Reference Type DERIVED
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Related Links

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https://www.e-jmis.org/journal/view.html?doi=10.7602/jmis.2018.21.1.43

Indocyanine Green-Fluorescent Pancreatic Perfusion-Guided Resection of Distal Pancreas in Solid Pseudopapillary Neoplasm: Usefulness and Feasibility During Pancreaticobiliary Surgery

Other Identifiers

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MO1012

Identifier Type: -

Identifier Source: org_study_id

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