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EUS-guided Transenteric Drainage With a Novel Lumen-apposing Metal Stent


2016-10


2018-10


2019-05


114

Study Overview

EUS-guided Transenteric Drainage With a Novel Lumen-apposing Metal Stent

To evaluate clinical efficacy and safety of a novel lumen-apposing FCSEMS for EUS-guided transenteric drainage of PFC or of biliary tree including GB

Patients with the following conditions would be recruited for drainage under EUS guidance with the new lumen apposing FCSEMS * Symptomatic or infected pancreatic pseudocyst or walled-off necrosis (WON) (SPAXUS 16 or 10 mm) * Acute cholecystitis by inoperable malignant diseases (SPAXUS 10 mm) * Acute cholecystitis by benign conditions with high-risk for operation (SPAXUS 10 mm) * Long-term cholecystostomy at high-risk for operation (SPAXUS 10 mm) * Symptomatic malignant obstruction of the distal CBD with unsuccessful transpapillary approach (the diameter of the CBD > 10 mm) (SPAXUS 8 or 10 mm) Outcome paramaters include technical and clinical success, adverse events.

  • Pancreatic Pseudocyst
  • Pancreatic Necrosis
  • Biliary Obstruction
  • Acute Cholecystitis
  • DEVICE: EUS-guided drainage
  • SPAXUS version 3.0

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

2016-12-16  

N/A  

2019-12-12  

2016-12-20  

N/A  

2019-12-13  

2016-12-23  

N/A  

2019-12  

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:
Treatment


Allocation:
Na


Interventional Model:
Single Group


Masking:
None


Arms and Interventions

Participant Group/ArmIntervention/Treatment
EXPERIMENTAL: EUS guided drainage

Patients suffering from the conditions in focus would receive EUS guided drainage with the lumen apposing stent

DEVICE: EUS-guided drainage

  • * Ultrasonographic evaluation of the lesion by linear echoendoscope and positioning for transenteric puncture in shortest distance between enteric wall and the target lumen for drainage. * EUS-guided transenteric puncture by using a 19-gauge needle follow
Primary Outcome MeasuresMeasure DescriptionTime Frame
Clinical success for pancreatic fluid collections① Clinical success of pancreatic fluid collections * Peudocyst: resolution more than 50% in the initial size of cyst. * Walled-off necrosis: resolution of PFC without the need for additional interventions after endoscopic interventions.8 hrs
Clinical success for acute cholecystitis- Afebrile for 8 hours, tolerating diet, absence of abdominal sign, or 20% decrease in white cell count.8hrs
Clinical success for obstructive jaundice- A decrease in total bilirubin to < 50 % of the pre-stenting value within 2 weeks.2 weeks
Secondary Outcome MeasuresMeasure DescriptionTime Frame
Techincal success- Satisfactory access, placement of stent and drainage.1 day
Adverse events* Bleeding: any hemorrhagic event during or after the procedure that required endotherapy, radiological interventions, blood product transfusion, or inpatient observation. * Perforation: perforation of the GI tract or cystic wall on imaging studies with peritonitis signs. * Pneumoperitoneum or pneumoretroperitoneum: intraperitoneal or retroperitoneal air on imaging study. * Stent migration: dislocation of the stent into the lumen or the GI tract on imaging study30 day

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:
20 Years

Accepts Healthy Volunteers:

    Inclusion Criteria:
    Patient must meet all of the following inclusion criteria to be eligible for enrollment into the study.

  • Pancreatobiliary diseases that are eligible for EUS-guided transenteric drainage
  • The patient who aged from 20 to 80 years. Legally acceptable representative must be capable of giving written informed consent prior to participation in this study
  • Target lesion that is accessible through the transenteric approach
  • The woman of child-bearing age must be negative from the pregnancy test in order to participate in this study
  • The patient who is willing and able to comply with the scheduled visits, treatment plan, laboratory tests, and other study procedures
  • The patients should not have any unacceptable conditions (e.g., physiological, familyism, social, geographical) for medical follow-up and adaptation of the study.

  • Exclusion Criteria:
    Patient presenting with any of the following will not be included in the study.

  • Inaccessible to EUS-guided approach
  • Bleeding tendency: International normalized ratio (INR) of prothrombin time < 1.5 or platelet conunt < 60,000/mm3
  • Patients with Disseminated Intravascular Coagulation syndrome(DIC)
  • Patients who have been taking medicines that can cause hemorrhage (e.g., Aspirin, Wafarin etc.)
  • Patients with other serious disease or medical condition
  • Patients with past medical history of significant neurologic or Psychiatric disorders such as dementia or seizure
  • Unstable heart disease despite of treatment, recent myocardial infarction within 6 month (Even though MI was diagnosed within 6 months, if it becomes stable presently, the patient can be possible to participate).

Collaborators and Investigators

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

  • SoonChunHyang University School of Medicine

  • PRINCIPAL_INVESTIGATOR: Anthony Teoh, Chinese University of Hong Kong

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

  • Teoh AYB, Kongkam P, Bapaye A, Ratanachu T, Reknimitr R, Lakthakia S, Chan SM, Gadhikar HP, Korrapati SK, Lee YN, Medarapalem J, Ridtitid W, Moon JH. Use of a novel lumen apposing metallic stent for drainage of the bile duct and gallbladder: Long term outcomes of a prospective international trial. Dig Endosc. 2021 Nov;33(7):1139-1145. doi: 10.1111/den.13911. Epub 2021 Jan 11.