Supra-papillary Versus Trans-papillary Biliary Stenting in Malignant Peri-hilar Stenosis

NCT ID: NCT07325877

Last Updated: 2026-01-08

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-03-01

Study Completion Date

2029-03-01

Brief Summary

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This is a randomized controlled trial comparing patients with obstructive jaundice due to malignancies of the perihilar area of bile ducts and undergoing both preoperative and palliative biliary drainage. The comparison will focus on the technique:, on the one hand, an arm of patients undergoing standard-of-care ERCP with trans-papillary plastic protesis placement, and on the other hand, an experimental arm of patients undergoing suprapapillary plastic protesis placement with no sphincterotomy. The primary objective will be to compare the time-to-stent dysfunction in the two groups; secondary objectives will include a comparison of the safety, technical, and clinical success of the procedures.

Detailed Description

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Conditions

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Biliary Disease Tract Biliary Stenosis Biliary Stents

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a single-blinded randomized controlled trial comparing two techniques used for the same procedure (ERCP and biliary stenting, suprapapillary vs transpapillary placement).
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Suprapapillary

ERCP for malignant stenosis of bile duct with suprapapillary stents positioning (experimental)

Group Type EXPERIMENTAL

ERCP with suprapapillary stent placement

Intervention Type PROCEDURE

ERCP with no sphincterotomy and placement of plastic stents above the papilla of Vater.

Trans Papillary

ERCP for malignant stenosis of bile duct with transpapillary stents positioning (Standard of care).

Group Type ACTIVE_COMPARATOR

ERCP with transpapillary stent placement

Intervention Type PROCEDURE

Standard ERCP with or without sphincterotomy with trans papillary stent placement

Interventions

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ERCP with suprapapillary stent placement

ERCP with no sphincterotomy and placement of plastic stents above the papilla of Vater.

Intervention Type PROCEDURE

ERCP with transpapillary stent placement

Standard ERCP with or without sphincterotomy with trans papillary stent placement

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Radiological/ biochemical/pathological diagnosis of malignant OJ.
2. Stenosis maximum extent may be 2 cm after biliary confluence.
3. Documented obstructive jaundice (serum bilirubin \> 3 mg/dL).
4. Indication for biliary drainage (preoperative or palliative).
5. Age ≥ 18 years.
6. Signed informed consent.

Exclusion Criteria

1. Contraindications to endoscopic approach (duodenal stenosis, surgically altered anatomy).
2. Previous sphincterotomy or drainage.
3. Involvement of the papilla of Vater by the tumour.
4. Uncontrolled coagulopathy (INR \> 1.5 uncorrectable or \<50.000 PLTs).
5. Ongoing uncontrolled cholangitis as defined according to the Tokyo 2018 Guidelines, or systemic sepsis.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Azienda Ospedaliera Universitaria Integrata Verona

OTHER

Sponsor Role lead

Responsible Party

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Andrea Ruzzenente

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Andrea Ruzzenente, Professor

Role: PRINCIPAL_INVESTIGATOR

Integrated University Hospital Verona

Stefano Francesco Crinò, Consultant

Role: STUDY_DIRECTOR

Integrated University Hospital Verona

Edoardo Poletto, PhD Candidate, Consultant

Role: STUDY_CHAIR

Integrated university Hospital Verona

Maria Cristina Conti Bellocchi, Consultant

Role: STUDY_CHAIR

Integrated University Hospital Verona

Central Contacts

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Andrea Ruzzenente, Professor

Role: CONTACT

+39 0458124644

Edoardo Poletto, PhD Candidate - Consultant

Role: CONTACT

+39 3452308635

References

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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Other Identifiers

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ID0001

Identifier Type: OTHER

Identifier Source: secondary_id

ID0001

Identifier Type: -

Identifier Source: org_study_id

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