EUS-directed Transenteric ERCP (EDEE) in Patients With Benign and Malignant Underlying Conditions and Inaccessible Papilla/Biliodigestive Anastomosis (BDA)

NCT ID: NCT07096895

Last Updated: 2025-07-31

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

RECRUITING

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-02-01

Study Completion Date

2027-01-01

Brief Summary

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Safety and efficacy of EDEE (EUS-directed transenteric ERCP)

Detailed Description

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Background and Study Objective Endoscopic retrograde cholangiopancreatography (ERCP) is considered the gold standard when biliary intervention is indicated. However, there are situations where conventional ERCP is no longer feasible - for example, in the presence of malignant gastric outlet obstruction.

Additionally, the number of patients with surgically altered anatomy due to benign or malignant underlying diseases is increasing. For this group of patients, enteroscopy-assisted ERCP can generally be considered. However, the success rate of this procedure varies depending on the anatomical situation and is only around 61.7%. Therefore, patients in whom the papilla or the biliodigestive anastomosis (BDA) cannot be reached either via conventional endoscopy or enteroscopy-assisted ERCP - yet require biliary intervention - present a particular clinical challenge.

Traditionally, the only option in such cases has often been percutaneous transhepatic drainage (PTBD). This approach frequently requires repeated procedures over several months and, in some cases, results in a permanent external drainage. In recent years, endoscopic ultrasound (EUS)-guided techniques have emerged as a promising treatment option for this patient population. These methods show a high technical success rate of approximately 90%, but are not suitable in cases requiring complex interventions (e.g., multiple strictures of the BDA) or when targeting the right biliary system.

An alternative approach involves a two-step procedure: first, an EUS-guided entero-enteric anastomosis is created using a lumen-apposing metal stent (LAMS); in a second step, ERCP is performed via the LAMS. This procedure is referred to in the literature as Endoscopic Ultrasound-Directed Transenteric ERCP (EDEE).

Since only a few systematic studies on this alternative procedure have been published so far, the objective of this retrospective study is to assess the technical and clinical success rates and evaluate the safety of EDEE.

Conditions

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Biliary Intervention Altered Anatomy Malignant Gastric Outlet Obstruction EUS Guided Enteroenteric Anastomosis EDEE

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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EDEE

Group Type EXPERIMENTAL

EDEE (EUS-directed transenteric ERCP)

Intervention Type PROCEDURE

Technical aspects of EUS-guided anastomosis and ERCP via LAMS (Lumen apposing metal stent)

Interventions

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EDEE (EUS-directed transenteric ERCP)

Technical aspects of EUS-guided anastomosis and ERCP via LAMS (Lumen apposing metal stent)

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* signed consent form
* Indication for an EDEE
* Age \>18 years

Exclusion Criteria

* Age \< 18 years
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Evangelisches Krankenhaus Düsseldorf

OTHER

Sponsor Role lead

Responsible Party

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Torsten Beyna

PD Dr. med

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Torsten PD Dr. med Beyna

Role: PRINCIPAL_INVESTIGATOR

Evangelisches Krankenhaus Düsseldorf

Locations

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Evangelisches Krankenhaus Düsseldorf

Düsseldorf, , Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Carina Friesl

Role: CONTACT

+49 211 919 2171

Leonie Dr. med. Grossmann

Role: CONTACT

+49 211 919 1605

Facility Contacts

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Carina Friesl

Role: primary

02119192171

Other Identifiers

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EDEE EVK Duesseldorf

Identifier Type: -

Identifier Source: org_study_id

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