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Intra-operative Application of HEMOPATCH to the Pancreatic Stump to Prevent Post-operative Pancreatic Fistula Following Distal Pancreatectomy


2018-08-13


2020-10-03


2020-10-23


52

Study Overview

Intra-operative Application of HEMOPATCH to the Pancreatic Stump to Prevent Post-operative Pancreatic Fistula Following Distal Pancreatectomy

Despite improvements and advances in pancreas surgery, about 30-35% of patients who have pancreas surgery develop a type of complication called a pancreatic fistula. A pancreatic fistula occurs when fluid produced by the pancreas leaks into the abdomen after pancreas surgery. Patients who develop a pancreatic fistula can have poor short-term and long-term consequences.We are studying the effect of a medical device named HEMOPATCH on the development and seriousness of pancreatic fistulas. HEMOPATCH is a thin, flexible bovine protein-based pad that may improve tissue sealing where it is applied during surgery. Some small studies called case studies of between 2 and 7 patients, and two clinical trials have shown that HEMOPATCH is effective at stopping bleeding and reducing drain output after some types of surgery. However, there have been no completed clinical trials using HEMOPATCH to prevent or reduce pancreatic fistulas in patients having pancreas surgery, so we don't know if it works in this setting. Health Canada has approved the use of HEMOPATCH as a device to stop bleeding or seal other bodily fluids for procedures in which the control of bleeding or leakage of other body fluids or air by standard surgical techniques are either ineffective or impractical.

N/A

  • Pancreas Cancer
  • Pancreas Disease
  • Pancreas Adenocarcinoma
  • Pancreas; Fistula
  • Surgery
  • Surgery--Complications
  • Surgery Site Fistula
  • DEVICE: Hemopatch
  • 346-2017

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates Results Reporting Dates Study Record Updates

2018-01-19  

2021-07-16  

2021-10-29  

2018-01-19  

2021-07-16  

2021-11-03  

2018-01-25  

2021-08-09  

2021-10  

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

Design Details

Primary Purpose:
Prevention


Allocation:
Na


Interventional Model:
Single Group


Masking:
None


Arms and Interventions

Participant Group/ArmIntervention/Treatment
EXPERIMENTAL: Hemopatch

Application of hemopatch to the divided end of the pancreas during surgery

DEVICE: Hemopatch

  • Application of hemopatch to the divided end of the pancreas during surgery.
Primary Outcome MeasuresMeasure DescriptionTime Frame
Number of Participants With a Clinically Significant Post-operative Pancreatic Fistula (POPF)Incidence of clinically-significant POPF - defined as ISGPS Grade B or C POPF. Determination of Grade B or C POPF was made on the basis of confirmation of presence of pancreatic fistula (any measurable volume of drain fluid on or after postoperative day 3, with an amylase content greater than 3 times the upper normal serum value) in conjunction with a review of participants' postoperative clinical course.Within 90 days post-operatively
Secondary Outcome MeasuresMeasure DescriptionTime Frame
Number of Participants With a Post-operative Pancreatic Fistula (POPF)Incidence of any POPF - defined as International Study Group Pancreatic Fistula (ISGPF) all grades (A, B, C). Determination of POPF grade was made on the basis of confirmation of presence of pancreatic fistula (any measurable volume of drain fluid on or after postoperative day 3, with an amylase content greater than 3 times the upper normal serum value) in conjunction with a review of participants' postoperative clinical course.Within 90 days post-operatively
Number of Participants Who Experienced Post-Operative ComplicationsPostoperative complications graded using the Clavien-Dindo system - participants experiencing a Clavien-Dindo complication of greater than or equal to 3 were counted (grade 3 or higher is typically indicated by a procedural intervention to treat the post-operative complication). This grading system was used as a measure of 90-day postoperative morbidity.Within 90 days post-operatively
90-Day Mortality CountIndicated by death within 90-days after surgery.Within 90 days post-operatively
Average Length of Stay in HospitalNumber of days from date of surgery (POD0) to the date of dischargeWithin 90 days post-operatively

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person’s general health condition or prior treatments.

Ages Eligible for Study:
ALL

Sexes Eligible for Study:
18 Years

Accepts Healthy Volunteers:

    Inclusion Criteria:

  • Scheduled to undergo distal pancreatectomy surgery that is open or laparoscopic, with or without splenectomy
  • Age ≥ 18 years
  • Able and willing to comply with study procedures and follow-up examinations contained within the written consent form

  • Exclusion Criteria:

  • Contraindication to placement of HEMOPATCH tissue sealant including: 1) Known hypersensitivity to bovine proteins; 2) Known hypersensitivity to brilliant blue [FD&C Blue No.1 (Blue 1)]; 3) Presence of an active infection; and 4) Known pregnancy or lactation (a negative urine pregnancy test must be obtained for women of child bearing potential during the pretreatment evaluation)
  • Participating in another interventional trial that may result in co-intervention or contamination (to be determined by sponsor)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

  • Baxter Healthcare Corporation
  • Hamilton Health Sciences Corporation
  • The Ottawa Hospital
  • Kingston Health Sciences Centre
  • Royal University Hospital Foundation
  • London Health Sciences Centre
  • University Health Network, Toronto

  • PRINCIPAL_INVESTIGATOR: Paul Karanicolas, MD, Sunnybrook Health Sciences Centre

Publications

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • Bubis LD, Behman R, Roke R, Serrano PE, Khalil JA, Coburn NG, Law CH, Bertens K, Martel G, Hallet J, Marcaccio M, Balaa F, Quan D, Gallinger S, Nanji S, Leslie K, Tandan V, Luo Y, Beck G, Skaro A, Dath D, Moser M, Karanicolas PJ; HPB CONCEPT team. PATCH-DP: a single-arm phase II trial of intra-operative application of HEMOPATCH to the pancreatic stump to prevent post-operative pancreatic fistula following distal pancreatectomy. HPB (Oxford). 2022 Jan;24(1):72-78. doi: 10.1016/j.hpb.2021.05.007. Epub 2021 Jun 9.