Early Pancreatic Stent Placement for Preventing PEP

NCT ID: NCT06250803

Last Updated: 2025-03-13

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

768 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-01

Study Completion Date

2026-03-01

Brief Summary

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Our aim is to compare early versus late pancreatic stent placement in preventing PEP among patients with naive papilla. The EVL trial will provide essential answers regarding the optimal timing of prophylactic pancreatic stent placement in PEP prevention.All patients with difficult biliary cannulation undergoing endoscopic retrograde cholangiopancreatography (ERCP) with pancreatic guidewire-assisted technique for biliary access will be told about the opportunity to participate in EVL research. In total, 768 patients will be randomly assigned (1:1) to two arms: (1) early pancreatic stent placement (EPSP) (a pancreatic stent will be placed immediately after endoscopic retrograde cholangiography (ERC) or endoscopic sphincterotomy (EST)) and (2) late pancreatic stent placement (LPSP) (a pancreatic stent will be placed after all completion of therapeutic biliary procedures, e.g. biliary stone removal or drainage).The primary outcome is the rate and severity of PEP. The secondary outcomes are hyperamylasemia, the rate of stenting success, and other ERCP-related adverse events (AEs).

Detailed Description

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Patients with challenging biliary access using pancreatic guidewire-assisted method will be enrolled in the study. Recruitment will take place among individuals referred to the four participating centers for therapeutic biliary procedures. After obtaining signed consent forms, participants who meet all the inclusion criteria and have no exclusion criteria will be randomly grouped (with a 1:1 ratio) into EPSP and LPSP

Conditions

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Cholangiopancreatography, Endoscopic Rretrograde Post-ERCP Pancreatitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
For enhanced objectivity in data analysis, the project statisticians will be blinded to the arm allocation.

Study Groups

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early pancreatic stent placement (EPSP)

a pancreatic stent will be placed immediately after endoscopic retrograde cholangiography (ERC) or endoscopic sphincterotomy (EST)

Group Type EXPERIMENTAL

early pancreatic stent placement (EPSP)

Intervention Type DEVICE

In the EPSP group, a single pig-tail pancreatic stent (5Fr) will be inserted instantly after ERC or EST, and subsequent biliary procedures will proceed as planned. In contrast, in the LPSP group, while keeping the PD guidewire in place, a single pig-tail PD stent (5Fr) will be ultimately placed after all completion of therapeutic biliary procedures, e.g. biliary stone removal or drainage.

late pancreatic stent placement (LPSP)

a pancreatic stent will be placed after all completion of therapeutic biliary procedures, e.g. biliary stone removal or drainage

Group Type OTHER

early pancreatic stent placement (EPSP)

Intervention Type DEVICE

In the EPSP group, a single pig-tail pancreatic stent (5Fr) will be inserted instantly after ERC or EST, and subsequent biliary procedures will proceed as planned. In contrast, in the LPSP group, while keeping the PD guidewire in place, a single pig-tail PD stent (5Fr) will be ultimately placed after all completion of therapeutic biliary procedures, e.g. biliary stone removal or drainage.

Interventions

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early pancreatic stent placement (EPSP)

In the EPSP group, a single pig-tail pancreatic stent (5Fr) will be inserted instantly after ERC or EST, and subsequent biliary procedures will proceed as planned. In contrast, in the LPSP group, while keeping the PD guidewire in place, a single pig-tail PD stent (5Fr) will be ultimately placed after all completion of therapeutic biliary procedures, e.g. biliary stone removal or drainage.

Intervention Type DEVICE

Other Intervention Names

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late pancreatic stent placement (EPSP)

Eligibility Criteria

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Inclusion Criteria

Participants who fulfill all the below criteria will be enrolled: 1. with naive papilla; 2. over 18 years; 3. undergoing ERCP with pancreatic guidewire-assisted technique for biliary access; 4. providing a signed, written informed consent.

Exclusion Criteria

Participants who meet any of the following criteria will be excluded: 1. unreachable main papillae; 2. surgically altered gastrointestinal anatomy; 3. concurrent acute pancreatitis; 4. biliary cannulation over pancreatic duct stent after precut sphincterotomy or wire-guided method (native early attribute); 5. failed biliary cannulation; 6. severe active cardiopulmonary disease; 7. breastfeeding or pregnancy; 8. ampullary tumour.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The First Affiliated Hospital of Bengbu Medical University

OTHER

Sponsor Role collaborator

Anqing Municipal Hospital

OTHER

Sponsor Role collaborator

First Affiliated Hospital of Wannan Medical College

OTHER

Sponsor Role collaborator

Tongcheng People's Hospital of Anhui province

UNKNOWN

Sponsor Role collaborator

Fuyang people's hospital

OTHER

Sponsor Role collaborator

The First Affiliated Hospital of Anhui Medical University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University

Hefei, Anhui, China

Site Status NOT_YET_RECRUITING

The First Affiliated Hospital of Anhui Medical University

Hefei, Anhui, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Qiao Mei, MD

Role: CONTACT

8613865977696

Junjun Bao, MD

Role: CONTACT

8613655697005

Facility Contacts

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Qiao Mei, MD

Role: primary

8613865977696

Junjun Bao, MD

Role: backup

8613655697005

Qiming Huang

Role: primary

17730145813

References

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Other Identifiers

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PJ 2023-14-12

Identifier Type: -

Identifier Source: org_study_id

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