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CompletedNCT03349424Updated Feb 13, 2020

Somatostatin Prevent Post-operation Pancreatic Fistula in Intermediate Risk Patients After Pancreaticoduodenectomy

A Phase 4 interventional study of Somatostatin in Pancreatic Fistula, sponsored by Peking Union Medical College Hospital. Completed at 1 site in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-02-13.

Sponsored by Peking Union Medical College Hospital · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
205
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study is designed to assess the preventive effects of somatostatin on post-operation pancreatic fistula in intermediate risk patients after pancreaticoduodenectomy. Patients assigned into the treatment group will be continuous intravenous infusion with the somatostatin (Stilamin®) in addition to conventional treatments (including infection prevention, nutrition support and acid suppression therapy, etc.).The pancreatic fistula incidence will be monitored within 30 days after operation.

Read the detailed description

This is a multi-center randomized, controlled clinical trial. A total of 200 patients are expected to be recruited. Each trial center recruits subjects based on the sequential principle and inspect the inclusion and exclusion criteria after PD and subjects meeting the standard are assigned randomly to the treatment group or control group. Apart from conventional treatments (including infection prevention, nutrition support and acid suppression therapy, etc.), the treatment group will be continuous intravenous infusion with the somatostatin (Stilamin®) of 250μg/h for 120h (total dose of 6mg/day x 5 days=30mg), beginning within 3 hours after the operation; the control group will accept conventional treatments other than the Stilamin.

The pancreatic fistula incidence, biochemical leak incidence, morbidity and number of other complications related to the pancreatectomy, length of stay in hospital, hospitalization cost, re-admission rate and re-operation rate will be monitored within 30 days after operation. Subjects will be visited for 5 times from the start to the end of the study.

Statistical Methods:Number of patients who had pancreatic fistula after surgery will be analyzed using Chi-square test.Secondary endpoints: Continuous variates will be described as mean± SD; attempted to be analyzed using analysis of variance. Categorical variates will be described as rate; attempted to be analyzed using Chi-square test.

02

Conditions studied

  • Pancreatic Fistula

Keywords

  • Somatostatin
  • Pancreatic Fistula
  • Intermediate Risk
  • Pancreaticoduodenectomy
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Age ≥ 18 year
  2. Patients underwent pancreaticoduodenectomy
  3. Fistula Risk Score recommended by ISGPS is intermediate risk
  4. Inform consent obtained

Exclusion criteria

Exclusion Criteria:

  1. Pervious pancreatic surgery history
  2. Received somatostatin or analogues treatment less than 5 half-life periods before surgery
  3. Known allergy to somatostatin or mannitol
  4. Woman who is pregnant, plan to be pregnant or during lactation period
  5. Attended other clinical trials within 30 days
  6. All contraindications to somatostatin (Stilamin®)
  7. Patients with any serious disease that investigator considers he/she should be excluded
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
205 participants (actual)

Study arms

  • Experimental
    Stilamin group

    Patients in the Stilamin group will be continuous intravenous infusion with the somatostatin in addition to postoperative conventional treatment.

    Drug: Somatostatin

  • No intervention
    Control group

    Patients in the control group will receive the postoperative conventional treatment, without addition of any new medicines.

Interventions

  • DrugSomatostatin

    Patients in the Stilamin group will be continuous intravenous infusion with the somatostatin (Stilamin®) of 250μg/h, beginning within 3 hours (Visit 1) after the operation and lasting for 120 hours (each subject will receive the Stilamin of 30mg in total), and other postoperative conventional treatment protocol remain unchanged.

    Also known as: Stilamin

05

What researchers measure

Primary outcomes

  1. Incidence of post-operative pancreatic fistula

    A clinically relevant postoperative pancreatic fistula is now defined as a drain output of any measurable volume of fluid with an amylase level \>3 times the upper limit of institutional normal serum amylase activity, associated with a clinically relevant development/condition related directly to the postoperative pancreatic fistula.

    Time frame: 30 days after operation

06

Study locations

1 site
  • Peking Union Medical College Hospital
    Beijing, Beijing 100730, China
07

References and documents

Publications

  • Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, Allen P, Andersson R, Asbun HJ, Besselink MG, Conlon K, Del Chiaro M, Falconi M, Fernandez-Cruz L, Fernandez-Del Castillo C, Fingerhut A, Friess H, Gouma DJ, Hackert T, Izbicki J, Lillemoe KD, Neoptolemos JP, Olah A, Schulick R, Shrikhande SV, Takada T, Takaori K, Traverso W, Vollmer CM, Wolfgang CL, Yeo CJ, Salvia R, Buchler M; International Study Group on Pancreatic Surgery (ISGPS). The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery. 2017 Mar;161(3):584-591. doi: 10.1016/j.surg.2016.11.014. Epub 2016 Dec 28. Erratum In: Surgery. 2024 Sep;176(3):988-989. doi: 10.1016/j.surg.2024.05.043. PubMed 28040257 ↗
  • Study Group of Pancreatic Surgery in Chinese Society of Surgery of Chinese Medical Association; Pancreatic Disease Committee of Chinese Research Hospital Association; Editorial Board of Chinese Journal of Surgery. [A consensus statement on the diagnosis, treatment, and prevention of common complications after pancreatic surgery (2017)]. Zhonghua Wai Ke Za Zhi. 2017 May 1;55(5):328-334. doi: 10.3760/cma.j.issn.0529-5815.2017.05.003. Chinese. PubMed 28464570 ↗
  • Callery MP, Pratt WB, Kent TS, Chaikof EL, Vollmer CM Jr. A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy. J Am Coll Surg. 2013 Jan;216(1):1-14. doi: 10.1016/j.jamcollsurg.2012.09.002. Epub 2012 Nov 2. PubMed 23122535 ↗
  • Gouillat C, Chipponi J, Baulieux J, Partensky C, Saric J, Gayet B. Randomized controlled multicentre trial of somatostatin infusion after pancreaticoduodenectomy. Br J Surg. 2001 Nov;88(11):1456-62. doi: 10.1046/j.0007-1323.2001.01906.x. PubMed 11683740 ↗
  • Cao Z, Qiu J, Guo J, Xiong G, Jiang K, Zheng S, Kuang T, Wang Y, Zhang T, Sun B, Qin R, Chen R, Miao Y, Lou W, Zhao Y. A randomised, multicentre trial of somatostatin to prevent clinically relevant postoperative pancreatic fistula in intermediate-risk patients after pancreaticoduodenectomy. J Gastroenterol. 2021 Oct;56(10):938-948. doi: 10.1007/s00535-021-01818-8. Epub 2021 Aug 28. PubMed 34453212 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03349424
Lead sponsor
Peking Union Medical College Hospital
Responsible party
zhang taiping (Deputy Director,Professor,Chief Physician of General Surgery Department, Peking Union Medical College Hospital) — Principal investigator
First posted
Nov 21, 2017
Start date
Jun 22, 2018
Primary completion
May 24, 2019
Completion
May 24, 2019
Last update
Feb 13, 2020

Study contacts

Yupei Zhao, MD
principal investigator · Peking Union Medical College Hospital

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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