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Trial registered on ANZCTR
Registration number
ACTRN12617001397303p
Ethics application status
Submitted, not yet approved
Date submitted
28/09/2017
Date registered
3/10/2017
Date last updated
3/10/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Endoscopic Ultrasound Guided Drainage of Bile in Patients with Benign Strictures of the Bile Duct
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Scientific title
Safety and Efficacy of Endoscopic Ultrasound Guided Biliary Drainage in Patients with Benign Biliary Strictures
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Secondary ID [1]
292948
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
EUS-BD in BBS
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Linked study record
none
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Health condition
Health condition(s) or problem(s) studied:
Benign Biliary Strictures
304843
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Condition category
Condition code
Oral and Gastrointestinal
304145
304145
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Interventional endoscopists who have performed numerous and various interventional endoscopic ultrasound procedures both locally and internationally, have trained overseas and attended courses on interventional endoscopic ultrasound will perform endoscopic ultrasound guided biliary drainage of benign biliary strictures by creating a fistula between the bile duct and stomach or duodenum using removable self expanding metal stents, face to face on patients with benign biliary strictures in a tertiary hospital. The average duration of the procedure is 40 minutes. Only one stent will be used for the study but if the stent to be placed becomes obstructed, then another stent will be placed. Blood samples will be taken to assess liver function on Day 2, week 2, month 1 then monthly unto 12 months post procedure.
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Intervention code [1]
299188
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Treatment: Devices
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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To determine the clinical success of endoscopic ultrasound guided biliary drainage defined by a reduction in serum bilirubin by 50% at 2 weeks
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Assessment method [1]
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Timepoint [1]
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2 weeks
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Secondary outcome [1]
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To determine the technical success of EUS guided stent placement as defined by the ability to insert a stent across a fistula between the biliary tree and the gastrointestinal tract
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Assessment method [1]
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Timepoint [1]
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Day of procedure
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Secondary outcome [2]
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To determine the incidence and severity of adverse events as defined by the American Society of Gastrointestinal Endoscopy
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Assessment method [2]
338990
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Timepoint [2]
338990
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Day of procedure, day 2 post procedure, week 2 post procedure and monthly post procedure until 12 months post procedure
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Secondary outcome [3]
338991
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To determine the average cost of endoscopic ultrasound guided biliary drainage by noting the quantity and cost of accessories used during the procedure and length of hospital stay
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Assessment method [3]
338991
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Timepoint [3]
338991
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Day of procedure until discharge of patient from hospital
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Secondary outcome [4]
338992
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To determine stent patency defined as time interval between stent placement and its occlusion
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Assessment method [4]
338992
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Timepoint [4]
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Day 2, Week 2, and monthly post procedure until 12 months post procedure
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Secondary outcome [5]
338993
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To determine the rate of biliary re-intervention which is defined as any intervention done to improve biliary drainage
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Assessment method [5]
338993
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Timepoint [5]
338993
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Day 2, week 2 and monthly post procedure until 12 months follow up
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Secondary outcome [6]
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Quality of Life using the SF-36 score
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Assessment method [6]
339223
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Timepoint [6]
339223
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one month then every month post procedure until 12 months
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Eligibility
Key inclusion criteria
Patients with obstructive jaundice secondary to benign biliary strictures for biliary drainage who have failed ERCP to access the bile duct because of failed cannulation and surgically altered anatomy requiring double balloon enteroscopy guided ERCP and who refuse percutaneous trans biliary drainage
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Minimum age
19
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients who are pregnant, who have bleeding tendency defined as having a platelet less than 50,000 or INR >1.5, PTT >50 seconds and malignant biliary strictures
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
not applicable
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
not applicable
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
This is a pilot study of 20 patients only
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
23/10/2017
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Actual
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Date of last participant enrolment
Anticipated
22/10/2018
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Actual
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Date of last data collection
Anticipated
21/10/2019
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Actual
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Sample size
Target
20
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
9087
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Royal Prince Alfred Hospital - Camperdown
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Recruitment postcode(s) [1]
17582
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2050 - Camperdown
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Funding & Sponsors
Funding source category [1]
297575
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Hospital
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Name [1]
297575
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Royal Prince Alfred Hospital
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Address [1]
297575
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50 Missenden Road Camperdown NSW 2050
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Country [1]
297575
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Australia
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Primary sponsor type
Individual
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Name
Payal Saxena
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Address
Royal Prince Alfred Hospital Medical Center, Suite G10, 100 Carillon Avenue, Newtown, NSW 2042
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
296589
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Arthur John Kaffes
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Address [1]
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Royal Prince Alfred Hospital Medical Center, Suite G10, 100 Carillon Avenue, Newtown, NSW 2042
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Country [1]
296589
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Australia
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
298668
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Royal Prince Alfred Hospital Research Ethics and Governance Office
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Ethics committee address [1]
298668
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Royal Prince Alfred Hospital 50 Missenden Road, CAMPERDOWN NSW 2050
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Ethics committee country [1]
298668
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Australia
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Date submitted for ethics approval [1]
298668
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09/08/2017
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Approval date [1]
298668
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Ethics approval number [1]
298668
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Summary
Brief summary
Endoscopic retrograde cholangiopancreatography has been the standard of care for the management of bile blockage. This procedure combines the use of x-rays and an endoscope (a long, flexible, lighted tube). During the procedure, the doctor can see the inside of the stomach and small intestine, and inject dye into the drainage tubes (ducts) of the pancreas or bile to see them more clearly on x-ray. However, this procedure is not always possible or successful due to altered anatomy related to surgery or disease related causes. Percutaneous transhepatic biliary drainage has been used as an alternative in these cases. During this procedure a tube to drain the bile ducts is introduced through the skin and liver. However, this procedure is associated with a number of complications such as bile leak, peritonitis, tube dislodgement, recurrent infection and bleeding. Endoscopic ultrasound is another procedure that uses sound waves to create visual images of the digestive tract, including the liver, bile ducts and pancreas. This procedure provides real time images and access to organs which are inaccessible by other means. Endoscopic ultrasound guided bile drainage is not a new procedure: several studies have looked at the safety and efficacy of this procedure in the management of bile blockage, however more studies are needed. This study aims to determine the efficacy and safety of bile drainage via endoscopic ultrasound for benign blockage when endoscopic X-ray procedure was unsuccessful. Data collected in the study will help to understand if endoscopic ultrasound is an equivalent or is better for bile drainage than a procedure performed introducing a tube via the skin into the bile duct.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
2078
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/AnzctrAttachments/373694-EUS BD in BBS Protocol v1 28June2017 submitted to ethics.docx
(Protocol)
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Contacts
Principal investigator
Name
77834
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Dr Payal Saxena
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Address
77834
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Royal Prince Alfred Hospital Medical Center, Suite G10, 100 Carillon Avenue, Newtown, New South Wales, 2042
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Country
77834
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Australia
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Phone
77834
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+61295162033
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Fax
77834
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Email
77834
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[email protected]
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Contact person for public queries
Name
77835
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Payal Saxena
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Address
77835
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Royal Prince Alfred Hospital Medical Center, Suite G10, 100 Carillon Avenue, Newtown, New South Wales, 2042
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Country
77835
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Australia
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Phone
77835
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+61295162033
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Fax
77835
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Email
77835
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[email protected]
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Contact person for scientific queries
Name
77836
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Payal Saxena
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Address
77836
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Royal Prince Alfred Hospital Medical Center, Suite G10, 100 Carillon Avenue, Newtown, New South Wales, 2042
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Country
77836
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Australia
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Phone
77836
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+61295162033
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Fax
77836
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Email
77836
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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