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Evaluation of a Novel Pancreaticojejunostomy Technique for Pancreaticoduodenectomy

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ClinicalTrials.gov Identifier: NCT01696903
Recruitment Status : Completed
First Posted : October 2, 2012
Last Update Posted : December 20, 2017
Sponsor:
Collaborator:
Information provided by (Responsible Party):

Study Description
Brief Summary:
Pancreaticoduodenectomy is a surgical procedure for removing cancer in the pancreas, the bile system or the duodenum that is associated with a high rate of complications. The study wants to investigate whether a new technique to reconstruct the joint between the pancreatic gland and the short bowel can reduce the rate of severe complications after this complex surgical procedure.

Condition or disease Intervention/treatment
Pancreatic Fistula Procedure: Pancreaticojejunostomy technique

Detailed Description:
Pancreaticoduodenectomy is a complex surgical procedure for radically resecting tumors in the pancreatic head, distal bile duct or duodenum. Postoperative pancreatic fistula is the main contributor of severe postoperative morbidity after pancreaticoduodenectomy. Characteristics of the pancreatic gland like soft pancreatic consistency and small pancreatic main duct predispose for the postoperative fistula development. In high risk patients, the risk of suffering from associated postoperative morbidity is 50 percent which is considered unacceptable high. The aim of the current trial is to investigate whether a new anastomosing technique for the pancreaticojejunostomy can reduce the incidence of associated postoperative morbidity in patients undergoing pancreaticoduodenectomy.

Study Design

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 123 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Clinical Randomized Trial Investigating a Novel Pancreaticojejunostomy Technique for Pancreaticoduodenectomy in Patients With a High Risk for Postoperative Pancreatic Fistula
Study Start Date : September 2011
Primary Completion Date : November 2015
Study Completion Date : November 2015

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Fistulas
U.S. FDA Resources

Arms and Interventions

Arm Intervention/treatment
No Intervention: Conventional anastomosis
Conventional anastomosis: The pancreaticojejunostomy is carried out in a traditional way according to "Cattell's duct-to-mucosa technique".
Active Comparator: Novel anastomosis
Novel anastomosis: This the active comparator to the conventional anastomosis. A new pancreaticojejunostomy technique is used for the reconstruction. The pancreas is intubated into the jejunum.
Procedure: Pancreaticojejunostomy technique
The anastomosis between jejunum and remnant pancreas has a pivotal impact on the incidence of postoperative pancreatic fistula. by this novel technique the remnant pancreas is intubated into the jejunum without extensive manipulation.
Other Names:
  • Pancreaticojejunal anastomosis
  • Intubating pancreaticojejunostomy
  • Dunking pancreaticojejunostomy
  • pancreatojejunostomy


Outcome Measures

Primary Outcome Measures :
  1. Clinically Relevant Postoperative Pancreatic Fistula [ Time Frame: participants will be followed for the duration of hospital stay, an expected average of 2 weeks ]
    Postoperative pancreatic fistula as defined by the International Study Group of Pancreatic Fistula


Secondary Outcome Measures :
  1. Associated postoperative morbidity [ Time Frame: participants will be followed for the duration of hospital stay, an expected average of 2 weeks ]
    Postoperative pancreatic fistula and abscesses or fluid collections adjacent to the pancreaticojejunostomy constitute a morbidity event; pancreaticojejunostomy-associated morbidity.


Other Outcome Measures:
  1. Severity of postoperative complications [ Time Frame: participants will be followed for the duration of hospital stay, an expected average of 2 weeks ]
    The severity of postoperative complications as classified by the classification system of postoperative complications adopted for pancreatic surgery.


Eligibility Criteria

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Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients scheduled for elective pancreaticoduodenectomy
  • Pancreatic gland with high risk criteria for associated postoperative morbidity

Exclusion Criteria:

  • Patients do not accept participation
  • Pancreatic gland with intermediate or low risk criteria for associated postoperative morbidity
Contacts and Locations

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 ClinicalTrials.gov identifier (NCT number): NCT01696903


Locations
Sweden
Department of Upper Abdominal Surgery, Linköping University Hospital
Linköping, Sweden, 58185
Department of Surgical gastroenterology, Karolinska University Hospital
Stockholm, Sweden, 14186
Sponsors and Collaborators
Karolinska Institutet
University Hospital, Linkoeping
Investigators
Principal Investigator: Christoph Ansorge, MD, PhD Karolinska Institutet
Study Director: Ralf Segersvärd, MD, PhD Karolinska Institutet
More Information

Additional Information:
Publications:
Responsible Party: Christoph Ansorge, Christoph Ansorge, MD, PhD, Karolinska Institutet
ClinicalTrials.gov Identifier: NCT01696903     History of Changes
Other Study ID Numbers: SKARV-GLH-001
KI-DSGE-DUAS ( Other Identifier: Karolinska Institutet )
First Posted: October 2, 2012    Key Record Dates
Last Update Posted: December 20, 2017
Last Verified: December 2017

Keywords provided by Christoph Ansorge, Karolinska Institutet:
Postoperative pancreatic fistula
Pancreatic texture
Pancreatic duct diameter
Pancreatic consistency
Pancreaticoduodenectomy

Additional relevant MeSH terms:
Fistula
Pancreatic Fistula
Pathological Conditions, Anatomical
Digestive System Fistula
Digestive System Diseases
Pancreatic Diseases