Does Post Operative Pancreatic Fistula, After Left Sided Resections, Heal Faster After the Introduction of a Pancreatic Stent?
|ClinicalTrials.gov Identifier: NCT02220010|
Recruitment Status : Unknown
Verified August 2014 by John Blomberg, Karolinska University Hospital.
Recruitment status was: Recruiting
First Posted : August 19, 2014
Last Update Posted : August 19, 2014
Dividing pancreas when performing left-sided resections opens the risk for leakage from the divided end of the pancreas. Pancreatic juices could have a severe effect on surrounding abdominal tissues with abscess formation producing systemic inflammation and potential lethal bleeding. Proper drainage of pancreatic juices is the primary treatment. Effective drainage reduces healing time. A pancreatic stent could theoretically improve the drainage of pancreatic juice into the duodenum and by this shorten the healing time still further.
Pre operative prophylactic stenting of the pancreas before division of the parenchyma has not shown a positive effect on fistula formation.
In an open randomized multicenter clinical trial we want to test the hypothesis that a reduced fistula healing time, in left sided pancreatic resections, could be reduced by introducing a pancreatic stent when on post operative day 3 or later a B och C fistula (according to the International Study Group on Pancreatic Fistula, ISGPF) is diagnosed by randomizing between pancreatic stent with drains versus only drains.
|Condition or disease||Intervention/treatment|
|Healing Time of Post Operative Pancreatic Fistulas||Device: Pancreatic stent|
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||60 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Official Title:||Does a Pancreatic Stent Reduce the Healing Time of Post Operative Pancreatic Fistula (POPF) After Distal Pancreatic Resection - an Open Randomized Clinical Multicenter Trial|
|Study Start Date :||June 2014|
|Estimated Primary Completion Date :||August 2017|
|Estimated Study Completion Date :||October 2017|
Experimental: Pancreatic stent
If POPF grade B or C is detected on post operative day 3 or more, a pancreatic stent is endoscopically positioned in the pancreatic duct.
Device: Pancreatic stent
The plastic stent is introduced in the pancreatic duct by a duodenoscope
Other Name: Pancreatic duct stent (made of plastic material)
No Intervention: Drain only
If POPF grade B or C is detected on post operative day 3 or more, only the per-operatively placed drain is used as treatment
- POPF healing time (days) [ Time Frame: 12 days (median hospital stay) ]Post operative pancreatic fistula(POPF) and grade (A,B,C) is diagnosed according to ISGPF on post operative day 3 or later if the pancrease-amylase concentration is more than three times the upper limit of the normal plasma concentration of pancreas-amylase. When the drain fluid concentration is below this value the fistula is defined as healed.
- POPF grade (A,B,C) [ Time Frame: 12 days (median hospital stay) ]International Study Group on Pancreatic Fistula (ISGPF) (Bassi et al 2005)defines fistula grade A-C. Grade A is leakage of pancreatic juice with a concentration of more than 3 times the upper normal level in plasma but no other clinical implication for the patient. If an inflammatory response is seen, but not sepsis, it is graded as B fistula and if sepsis occurs and/or single- or multi-organ dysfunction is seen it is graded as C.
- Blood chemistry [ Time Frame: 12 days (median hospital stay) ]C-reactive protein, white blood cell count and pancreas amylase in plasma and drains
- Morbidity [ Time Frame: 12 days (median in hospital stay) ]Classification according to Clavien-Dindo
- Mortality [ Time Frame: < 90 days after the operation ]
- Hospital stay [ Time Frame: 12 days (median hospital stay) ]Number of days in hospital
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02220010
|Dep of Surgical Gastroenterology, Karolinska University Hospital||Recruiting|
|Stockholm, Sweden, SE-141 86|
|Contact: John Blomberg, MD, PhD +46(0)703983060 email@example.com|
|Contact: Christoph Ansorge, MD, PhD firstname.lastname@example.org|
|Principal Investigator: John Blomberg, MD, PhD|
|Sub-Investigator: Christoph Ansorge, MD, PhD|