RecruitingNot ApplicableNCT04037007

Efficacy of Fistulotomy for Biliary Cannulation

Efficacy and Safety of Precut Fistulotomy vs Conventional Cannulation Technique as a Primary Approach to Biliary Access According to the Endoscopist Experience Degree in ERCP


Sponsor

Coordinación de Investigación en Salud, Mexico

Enrollment

320 participants

Start Date

Jul 3, 2019

Study Type

INTERVENTIONAL

Conditions

Summary

Access to the main bile duct is the first step in order to perform a therapeutic maneuver for biliary diseases. Early precut has been shown to ameliorate cannulation success rate, specially in difficult cannulation cases, when compared to guidewire cannulation (which is considered, for most, the standard technique). We aim to perform a randomized clinical trial comparing fistulotomy (F) precut vs guidewire cannulation (CC), as a primary cannulation technique, and compare outcomes between high experienced endoscopists (\> 200 ERCPs\[Endoscopic Retrograde cholangiopancreatography\]) and low experienced endoscopists (\< 200 ERCPs).


Eligibility

Min Age: 18 YearsMax Age: 90 Years

Plain Language Summary

Simplified for easier understanding

This study evaluates whether a specific technique called fistulotomy makes it easier and safer for doctors to access the bile duct during a procedure called ERCP (endoscopic retrograde cholangiopancreatography), which is used to treat blockages or problems in the bile duct. **You may be eligible if...** - You are scheduled for an ERCP procedure to access the bile duct - Standard cannulation (inserting a tube into the bile duct) is expected to be or has been difficult - You are 18 or older **You may NOT be eligible if...** - You have had previous surgery that has changed the normal anatomy of your bile duct area - You have conditions that make ERCP too risky - You are pregnant Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

PROCEDUREFistulotomy - High experienced.

We will perform a duodenoscopy, once located next to the papilla, we will perform precut fistulotomy on the papillary infundibulum with a needle knife with EBRE, EndoCut I, Effect 2, until biliary fluid exit is seen or the biliary duct is noted, then we will access to the biliary tree to complete de procedure.

PROCEDUREFistulotomy - Low experienced.

We will perform a duodenoscopy, once located next to the papilla, we will perform precut fistulotomy on the papillary infundibulum with a needle knife with EBRE, EndoCut I, Effect 2, until biliary fluid exit is seen or the biliary duct is noted, then we will access to the biliary tree to complete de procedure.

PROCEDUREConventional (guidewire) cannulation- High experienced

We will perform a duodenoscopy, once located next to the papilla, we will perform cannulation with sphincterotome and hydrophilic tipped guidewire aided by fluoroscopy, once the guidewire reaches de common bile duct (seen on fluoroscopy) we will continue with the procedure according to the patient's indication.

PROCEDUREConventional (guidewire) cannulation - Low experienced

We will perform a duodenoscopy, once located next to the papilla, we will perform cannulation with sphincterotome and hydrophilic tipped guidewire aided by fluoroscopy, once the guidewire reaches de common bile duct (seen on fluoroscopy) we will continue with the procedure according to the patient's indication.


Locations(1)

Centro Medico Nacional Siglo XXI Hospital de Especialidades

Mexico City, Mexico City, Mexico

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NCT04037007


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