ENHANCED RECOVERY AFTER BILIARY TRACT SURGERY

Not Applicable

• Conditions: Cholangitis; Choledocholithiasis; Cholangiocarcinoma; Biliary Stricture
• Interventions: Combination Product: Enhanced recovery after biliary tract surgery

• Registration Number: NCT04633382
• Lead Sponsor: Vitebsk State Medical University

Brief Summary

The aim of the study is to improve the immediate results after reconstructive and restorative operations on the biliary tract by substantiating the management of the perioperative period on the principles of "enhanced recovery after surgery".

Detailed Description

A prospective randomized study on the effect of fast-track surgery on the immediate postoperative results after various reconstructive and restorative operations on the bile ducts. In the Department of Surgical Hepatology and Transplantation, a prospective randomized study will include patients (about 50) with planned reconstructive and restorative operations on the bile ducts for malignant and benign diseases of the bile ducts.

Study Timeline

• Status Verified: 2020-11
• Study First Submitted: 2020-11-12
• Study First Submitted QC: 2020-11-12
• Last Update Submitted: 2020-11-17
• Study First Posted: 2020-11-18
• Last Update Posted: 2020-11-19
• Study Start: 2021-01-01
• Primary Completion: 2021-01-31
• Study Completion: 2022-01-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

1. Patients with malignant diseases of the biliary tract (cholangiocarcinoma):

   1.1. tumor resectability 1.2. absence:

   • distant metastases
   • carcinomatosis
   • perforation of the tumor and peritonitis
   • sprouting into adjacent organs and tissues (locally advanced cancer)
   • total adhesion process in the abdominal cavity (after previous operations). 1.3. Planned reconstructive surgery on the biliary tract.

2. Patients with benign biliary tract pathology. 2.1. Planned reconstructive or restorative surgery on the biliary tract for the following diseases:

   • choledocholithiasis
   • Mirizzi syndrome
   • cysts of the common bile duct
   • strictures of the common bile duct
   • injuries to the bile ducts
   • adenoma and stricture of the OBD

Exclusion Criteria

1. Scale ASA> III (severe concomitant cardiovascular pathology).
2. Palliative reconstructive surgery.
3. Previously performed operations on the bile ducts (up to 1 month).
4. Cachexia.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Conducting research of traditional recovery after surgery	Enhanced recovery after biliary tract surgery	1. Informing the patient about the course of the operation and the postoperative period. Psychological preparation. 2. Fasting for 2 days 3. Use of cleansing enemas. Bowel preparation 4. Premedication 5. Prevention of thromboembolic complications 6. Without multimodal analgesia 7. Traditional access. 8. Prevention of hypothermia 9. Targeted infusion therapy. 10. Use of drains: gastric, intra-abdominal, bile duct drainage. 11. Activation of patients within 2 days. 12. Enteral nutrition after 2 days after surgery. 13. Without the use of metoclopramide
Conducting research of enhanced recovery after surgery	Enhanced recovery after biliary tract surgery	1. Informing the patient about the course of the operation and the postoperative period. Psychological preparation. 2. Refusal from complete starvation. Carbohydrate drink 2 hours before surgery. 3. Refusal of cleansing enemas. 4. Refusal of premedication. NSAIDs 30 minutes before surgery 5. Prevention of thromboembolic complications 6. Multimodal analgesia: epidural catheter, paracetamol. 7. Minimally invasive access. 8. Prevention of hypothermia 9. Targeted infusion therapy. 10. Failure or limited time use of drainages: gastric, intra-abdominal, bile duct drainage. 11. Early activation of the patient. 12. Early enteral nutrition. 13. Prevention of nausea and vomiting.

Primary Outcome Measures

Name	Time	Method
Reduction of bed-days	1 week	Improvement of basic health indicators, absence of complications, reduction of bed days