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Spyglass+RFA Versus Cytobrush+RFA for Extrahepatic Cholangiocarcinoma

Not Applicable
Conditions
Extrahepatic Cholangiocarcinoma
Malignant Biliary Obstruction
Interventions
Procedure: Spyglass + RFA
Procedure: Cytobrush + RFA
Registration Number
NCT05233293
Lead Sponsor
First People's Hospital of Hangzhou
Brief Summary

With the development of endoscopic technology, endoscopic retrograde cholangiopancreatography (ERCP) has been widely used in the diagnosis and treatment of extrahepatic cholangiocarcinoma.In patients with extrahepatic cholangiocarcinoma, cytological brushing performed concurrently with ERCP had a lower pathologically positive rate and increased the times of ERCPs, increased the risk of postoperative complications at the same time.The present study aims to compare the efficacy and safety outcomes of Spyglass+RFA Versus Cytobrush+RFA for Extrahepatic Cholangiocarcinoma.

Detailed Description

Endoscopic retrograde cholangiopancreatography (ERCP) has been used as the primary method for the diagnosis of biliary strictures and the treatment of extrahepatic cholangiocarcinoma. However, the accurate visual diagnosis of malignant biliary strictures and assessment of the extent of a lesion are not possible by ERCP, and treatment of extrahepatic cholangiocarcinoma by ERCP procedures is sometimes difficult. In patients with extrahepatic cholangiocarcinoma, cytological brushing performed concurrently with ERCP had a lower pathologically positive rate and increased the times of ERCPs, increased the risk of postoperative complications at the same time. Spyglass enables direct visualization of the biliary tract and the sampling of suspicious lesions, together with radiofrequency ablation.Endoscopic radiofrequency ablation (RFA) is an emerging technique for the palliation of inoperable malignant biliary strictures (MBSs). In a dozen published studies, this novel approach has shown better safety and feasibility, as well as improvement in overall survival (OS). The present study aims to compare the efficacy and safety outcomes of Spyglass+RFA Versus Cytobrush+RFA for Extrahepatic Cholangiocarcinoma.

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Age >18 years ;
  • Patients with high suspicion of extrahepatic cholangiocarcinoma such as unexplained bile duct stenosis or elevated CA19-9 were found according to relevant imaging studies or symptoms;
  • Willing to abide by the research procedures and sign the informed consent.
Exclusion Criteria
  • Myocardial infarction within 3 months;
  • Renal insufficiency (Scr>177 umol/L);
  • Serious cardiovascular and cerebrovascular or respiratory diseases before surgery;
  • Preoperative shock manifestations, such as hypotension ( Systolic blood pressure <90mmHg) or increased heart rate (>120 beats/min);
  • Pregnancy and lactation;
  • Allergic to NSAIDs; Other clinical observation trials or those who have participated in other clinical trials within 60 days;
  • Cases deemed inappropriate by the investigator (such as those with clear contraindications to ERCP).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
SpyGlass groupSpyglass + RFAERCP plus SpyGlass plus RFA group
Cytobrush GroupCytobrush + RFAERCP plus Cytobrush plus RFA group
Primary Outcome Measures
NameTimeMethod
complications1 month

Incidence of Postoperative complications such as bleeding and infection

Pathological positive rate1 month

Malignant tumor diagnosis rate

Secondary Outcome Measures
NameTimeMethod
Number of sessions1 month

Number of ERCP and RFA procedures

Procedure TimeIntraoperative

Time spent for each surgery

Trial Locations

Locations (1)

Hangzhou First People's Hospital

🇨🇳

Hangzhou, Zhejiang, China

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