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Trial registered on ANZCTR
Registration number
ACTRN12609000162213
Ethics application status
Approved
Date submitted
24/03/2009
Date registered
1/04/2009
Date last updated
1/04/2009
Type of registration
Prospectively registered
Titles & IDs
Public title
Prospective randomized trial of two-stage treatment with preoperative endoscopic retrograde cholangiopancreatography (ERCP) versus single-stage treatment with intraoperative ERCP in patients with gallbladder and bile duct stones
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Scientific title
Prospective randomized trial of two-stage treatment with preoperative endoscopic retrograde cholangiopancreatography (ERCP) versus single-stage treatment with intraoperative ERCP in patients with gallbladder and bile duct stones for stone clearance
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Patients with gallbladder and bile duct stones
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Condition category
Condition code
Surgery
4810
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Single-stage treatment with intraoperative ERCP (ERCP is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain disease of the biliary or pancreatic ductal systems, e.g. biliary stone. Then a flexible endoscope is inserted through the mouth, into the duodenum where the ampulla of Vater exists. The region can be directly visualized with the endoscopic camera. A plastic cannula is inserted through the ampulla, and radiocontrast is injected into the bile ducts. Fluoroscopy is used to look for any pathology such as stones. Then, endoscopist can treat it accordingly. The procedure lasts around 30 minutes) and laparoscopic cholecystectomy (Gallbladder with stones was dissected and removed by minimally invasive surgery with laparoscopic approach by four small wound ports. Intraoperative cholangiogram may be performed also, if needed. The procedure lasts around 90 minutes); Patients will undergo laparoscopic cholecystectomy and intraoperative ERCP simutaneously under general anestheisa.
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Intervention code [1]
4281
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Treatment: Surgery
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Comparator / control treatment
Two-stage treatment with preoperative ERCP (ERCP will be performed under sedation; The procedure lasts around 30 minutes) and then laparoscopic cholecystectomy (The procedure lasts around 90 minutes); Patients will undergo preoperative ERCP and after a short period of clinical monitoring (24–72 hours), laparoscopic cholecystectomy will be received.
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Control group
Active
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Outcomes
Primary outcome [1]
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Failure of ERCP (inability to visualize or to cannulate the common bile duct)
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Assessment method [1]
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Timepoint [1]
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After ERCP
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Secondary outcome [1]
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Failure of stones extraction (inability to obtain complete common bile duct stones clearance at completion cholangiogram)
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Assessment method [1]
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Timepoint [1]
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After ERCP
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Eligibility
Key inclusion criteria
1. Age ranged from 18-75 years old
2. Patients with ultrasonography(USG)/magnetic resonance cholangiopancreatography (MRCP)/computed tomography (CT) scan evidence of gallbladder stones and common bile duct (CBD) stones
3. Patients recovered from episode of acute cholangitis or biliary pancreatitis, and were treated with ERCP and temporary biliary stenting for the biliary stone obstruction during acute phase. Patients were randomized only if they demonstrated evidence of resolved acute episode, as determined by a decreasing white cell count, bilirubin level, fever and reduced abdominal pain
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Patients with acute cholangitis or acute severe pancreatitis at acute phase
2. American Society of Anesthesiologists (ASA) class IV and V health status
3. Patients with suspected biliary malignancy
4. Patients with Mirizzi syndrome
5. Patients with recurrent pyogenic cholangitis
6. Patients with previous cholecystectomy/bile duct exploration/gastrectomy
7. Patients have contraindications to ERCP/laparoscopic surgery
8. On long term anticoagulant treatment
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/04/2009
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
88
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Hong Kong
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State/province [1]
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
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Primary sponsor type
Hospital
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Name
Department of Surgery, Pamela Youde Nethersole Eastern Hospital
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Address
3 Lok Man Road, Chai Wan, Hong Kong
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Country
Hong Kong
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Ethics Committee of Hong Kong East Cluster of Hospital Authority
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Ethics committee address [1]
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Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong
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Ethics committee country [1]
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Hong Kong
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Date submitted for ethics approval [1]
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Approval date [1]
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20/03/2009
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Ethics approval number [1]
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HKEC-2009-006
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Summary
Brief summary
The ideal management of common bile duct stones (CBD) in the era of laparoscopic cholecystectomy remains controversial. However, ERCP remains the prevailing method of treating CBD stones, but its ideal timing in respect to laparoscopic cholecystectomy is not defined yet.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Lai Eric C.H.
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Address
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Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong
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Country
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Hong Kong
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Phone
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852-2595 6111
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Lai Eric C.H
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Address
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Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong
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Country
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Hong Kong
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Phone
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852-2595 6111
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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