Endosonography-guided Gallbladder Drainage vs Non-endoscopic Treatment in Patients With Inoperable Acute Cholecystitis: a Multicenter Randomized Clinical Trial (EUS-DRAIN)

Status: Recruiting
Location: See location...
Intervention Type: Procedure
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

In this project the investigators propose to carry out a clinical trial that compares non-endoscopic treatment of cholecystitis with antibiotics versus endoscopic drainage in non-operable acute cholecystitism (AC), especially focused on the rate of subsequent EBP and recurrence of AC, as well as the impact on the quality of life, also exploring the costs. The ultimate goal of this project is to generate knowledge and scientific evidence that makes it easier for health professionals to choose the most appropriate strategy for non-operable patients with lithiasic AC. Ourworking hypothesis is that endoscopic treatment (EUS-GBD) will significantly reduce the number of EBP compared to non-endoscopic treatment in patients with non-operable lithiasic AC.

Eligibility
Participation Requirements
Sex: All
Healthy Volunteers: f
View:

• Patient older than 18 years.

• Definitive diagnosis of acute lithiasic cholecystitis according to the GP Tokyo 2018 criteria.

• Surgical decision of inoperable patient (if one or more of the following criteria is met: age ≥80 years, American Society of Anesthesiology (ASA) III or more, Charlson Comorbidity Index \> 5 and/or Karnofsky \< 50 or decision of the patient not to have surgery.

• Signature of the informed consent of the study

Locations
Other Locations
Spain
Hospital Universitario de Navarra
RECRUITING
Pamplona
Contact Information
Primary
Jesús JU Urmán, PhD
jmurmanf@gmail.com
+(34) 8484422222
Time Frame
Start Date: 2022-10-01
Estimated Completion Date: 2026-07-01
Participants
Target number of participants: 100
Treatments
No_intervention: Non-endoscopic treatment group (Group NE)
Antibiotic treatment will start from the moment of diagnosis in both arms of the study. Following the recommendations of the Clinical Practice Guideline for the Management of Acute Cholecystitis of Tokyo 2018, CAL will be classified into three groups according to severity (I,II,III) and empirical antibiotic treatment will be started according to the recommendations of said guideline
Experimental: Endoscopic treatment group (EUS-GBD Group)
The procedure will be performed after at least 6 hours of fasting The placement of the drain will be performed using a linear echoendoscope that allows the gallbladder to be punctured from the gastric antrum or the duodenal bulb to generate a cholecystogastrostomy or a cholecystoduodenostomy, respectively. Transmural gallbladder drainage will be performed by placing a metal apposition stent (LAMS) with the 15x15mm Hot AXIOS device (Boston Scientific) in the case of cholecystogastrostomy or 15x10 or 10x10mm in the case of cholecystoduodenostomy.
Related Therapeutic Areas
Sponsors
Leads: Fundacion Miguel Servet

This content was sourced from clinicaltrials.gov