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N/A N=284 Randomized Treatment

Preoperative Biliary Drainage in Resectable Pancreatic or Periampullary Cancer

Pancreatic Carcinoma

Enrolled (actual)
284
Serious AEs
26.8%
Results posted
Apr 2023
Primary outcome: Primary: Number of Serious Pre-operative, Operative and Post-operative Adverse Events to 120 Days Post Randomization or to 30 Days Post Surgery, Whichever Comes Last — 40; 36 Participants

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
WallFlex™ Biliary RX Fully Covered/Uncovered Stent System (Device)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Boston Scientific Corporation
Primary completion
Dec 2021

Outcome Measures

OutcomeResultp-value
PRIMARY
Number of Serious Pre-operative, Operative and Post-operative Adverse Events to 120 Days Post Randomization or to 30 Days Post Surgery, Whichever Comes Last
40; 36
SECONDARY
Stent Placement Success
140
SECONDARY
Number of Patients With Biliary Re-interventions
8; 12
SECONDARY
Success Rate of Curative Intent Surgery
103; 115
SECONDARY
All-cause Mortality
11; 11

Summary

The purpose of this study is to demonstrate that preoperative biliary drainage using self-expanding metal stents (SEMS) does not negatively impact overall surgical outcomes in patients undergoing pancreaticoduodenectomy for treatment of pancreatic or periampullary cancer.

Eligibility Criteria

Inclusion Criteria

  • Age 18 or older
  • Willing and able to comply with the study procedures and provide written informed consent to participate in the study
  • Diagnosis of probable pancreatic cancer, distal common bile duct (CBD) cholangiocarcinoma and other periampullary cancers (histology not required)
  • Biliary obstructive symptoms or signs
  • Bilirubin level at/above 100 umol per liter (5.8 mg/dL)
  • Distal biliary obstruction consistent with pancreatic cancer, distal CBD cholangiocarcinoma or other periampullary malignancy
  • Location of distal biliary obstruction is such that it would allow the proximal end of a stent to be positioned at least 2cm from the hilum
  • Patients deemed as resectable by pancreatic protocol CT or MRI
  • Surgical candidate per pancreatobiliary surgeon after multi-disciplinary discussion
  • Surgery intent within 4 weeks
  • Endoscopic and surgical treatment to be provided by same team

Exclusion Criteria

  • Biliary strictures caused by confirmed benign tumors
  • Biliary strictures caused by malignancies other than pancreatic cancer, distal CBD cholangiocarcinoma and other periampullary cancers
  • Surgically altered biliary tract anatomy, not including prior cholecystectomy
  • Neoadjuvant chemotherapy for current malignancy
  • Palliative indication due to reasons other than surgical candidate status
  • Previous biliary drainage by ERCP/PTC
  • Patients for whom endoscopic techniques are contraindicated
  • Participation in another investigational trial within 90 days
  • Pregnancy
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01774019). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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