Endoscopic Treatment of Biliary Strictures After LTX: Balloon Dilatation Versus Stent Placement

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00487201
Recruitment Status : Completed
First Posted : June 15, 2007
Last Update Posted : June 18, 2007
Information provided by:
University of Ulm

Brief Summary:

Background and Study Aims: Biliary strictures are a major cause of morbidity following liver transplantation with an overall incidence between 10 and 30 %. Up to now biliary strictures were dilated subsequently one to three plastic stents with a diameter of eight to ten F were inserted. In general, stents were exchanged in two to three months intervals over one year. In the present prospective controlled study, efficacy and complication rates of balloon dilation have been compared with dilation plus stenting.

Patients and Methods: XY patients with high-grade biliary strictures (anastomotic and non-anastomotic) were enrolled in this prospective study in random order. X patients were treated by endoscopic balloon dilatation and Y by balloon dilatation plus plastic stent placement in six to eight weeks intervals. The primary end point was permanent opening of the biliary obstruction of 12 months. Number of endoscopic interventions and complications of the procedures were monitored.

Condition or disease Intervention/treatment Phase
Biliary Obstruction Biliary Stenosis Biliary Stricture Procedure: endoscopic balloon dilatation Procedure: plastic stent placement Not Applicable

Detailed Description:

Endoscopic treatment was performed by experienced endoscopists who had each performed more than 1000 ERCP procedures. The procedure was performed with the patient under general anesthesia with propofol. A stenosis was considered to be present if the cholangiogram showed strictures with a narrowing of the anastomosis or the proximal donor duct site of the anastomosis and incomplete distal runoff of the contrast agent.

The patients were divided into two groups: 1) balloon dilatation of the stricture, 2) balloon dilatation plus plastic stent placement.

In both groups, endoscopic treatment of the patients comprised sphincterotomy, consecutive dilation of stenosis up to 10 F, removement of occluding material from choledochus duct using a balloon catheter if necessary, and repetitive balloon dilatation of the anastomosis stricture or of the non-anastomotic proximal donor duct stricture to 18 F at the first intervention and to 24 F in the following interventions.

The second group of the patients were additionally treated by large-diameter (10 F) plastic stent placement after balloon dilatation. This procedure was repeated in 6 - 8 weeks intervals in both groups.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 22 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Study Start Date : April 2006
Actual Study Completion Date : May 2007

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Aneurysms Endoscopy

Primary Outcome Measures :
  1. Permanent opening of the biliary obstruction. [ Time Frame: 12 months ]

Secondary Outcome Measures :
  1. number of endoscopic interventions and complications of the procedures [ Time Frame: 12 months ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • liver transplanted patients with diagnosis of biliary obstruction based on endoscopic cholangiopancreaticography older than 18 years male and female

Exclusion Criteria:

  • patients with multiple organ transplantation

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00487201

Uniklinikum Heidelberg
Heidelberg, Baden-Württemberg, Germany
Medizinische Universitätsklinik Ulm
Ulm, Baden-Württemberg, Germany, 89081
Sponsors and Collaborators
University of Ulm
Principal Investigator: Hasan Kulaksiz, PD Dr. Medizinische Universitätsklinik Ulm, Innere Medizin I

Publications: Identifier: NCT00487201     History of Changes
Other Study ID Numbers: 120-2006
First Posted: June 15, 2007    Key Record Dates
Last Update Posted: June 18, 2007
Last Verified: May 2007

Keywords provided by University of Ulm:
liver transplantation
biliary strictures

Additional relevant MeSH terms:
Constriction, Pathologic
Pathological Conditions, Anatomical
Bile Duct Diseases
Biliary Tract Diseases
Digestive System Diseases