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NCT05141916

Optimizing the Evaluation and Management of Patients With Suspected Choledocholithiasis

Status unknown Last updated 9 January 2024
What this trial tests

trial testing Endoscopic Retrograde Cholagiopancreatography (ERCP) in Biliary Disease in 2,000 participants. Status unknown.

Timeline
25 February 2019
Primary endpoint
31 December 2025
31 March 2026

Quick facts

Lead sponsorUniversity of Calgary
StatusStatus unknown
Study typeOBSERVATIONAL
Enrollment2,000
Start date25 February 2019
Primary completion31 December 2025
Estimated completion31 March 2026
Sites1 location across Canada

Drugs / interventions tested

Conditions studied

Sponsor

University of Calgary

Who can join

18 and older, any sex, with Biliary Disease or Choledocholithiasis. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Choledocholithiasis (stone(s) in the common bile duct) is common. Untreated or missed, choledocholithiasis has high morbidity and mortality. Endoscopic retrograde cholangio-pancreatography (ERCP) is recognized as the first-line modality for management. While effective, ERCP is associated with adverse events. Thus, the selection of patients for ERCP should be accompanied by a high pre-test suspicion of choledocholithiasis. Choledocholithiasis is suspected based on clinical, biochemical and radiographic findings. The most relied-upon strategy for risk stratification of choledocholithiasis is based on guidelines from The American Society for Gastrointestinal Endoscopy (ASGE). In it, clinical predictors are defined as "very strong", "strong" or "moderate", and the presence of one or more of these is meant to suggest "high" or "intermediate" probability of choledocholithiasis. A knowledge gap exists in the performance characteristics of intermediate-probability criteria, where overall accuracy is \<50% from limited data. Patients in this group are recommended to a) undergo endoscopic ultrasound (EUS) or magnetic resonance cholangio-pancreatography (MRCP), b) undergo cholecystectomy with intra-operative cholangiography (IOC), or c) proceed directly to ERCP. At centres where EUS and MRCP are readily available, these are preferred options, as they are least invasive and sensitive; however, they are often unavailable. Thus, in clinical practice, a high proportion of intermediate-risk patients ultimately proceed directly to ERCP, where likelihood of benefit is only moderate, while procedural risk remains. The role of liver enzyme changes has not been evaluated; however, dynamic changes may offer another method for evaluating patients at intermediate risk of CBD stones that is safe and available. Incorporation of dynamic liver enzymes may improve the test-performance characteristics of the existing framework.

Publications & conference data

No peer-reviewed publications indexed yet for this trial.

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Other recruiting trials for Biliary Disease

Currently open trials in the same condition.

Other University of Calgary trials

Trials by the same sponsor.

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Data sources for this page

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing