An interventional study of Magnetic Compressive Anastomosis and Manual Anastomosis in Pancreatic Cancer, Cholangiocarcinoma and Bile Duct Injury, sponsored by First Affiliated Hospital Xi'an Jiaotong University. Status unknown at 1 site in China. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2019-11-18.
Sponsored by First Affiliated Hospital Xi'an Jiaotong University · Not applicable, Interventional, and Treatment
The purpose of this study is to determine whether the magnetic compressive anastomosis has a better outcomes than traditional manual anastomosis on bilioenteric anastomosis.
The bilioenteric anastomosis is one of the most common and difficult operations in Hepatobiliary Surgery. The traditional manual anastomosis has become one of the main prognosis factors because of the length of suture time, the difficulty of operation, the high incidence of anastomotic leakage and stricture. Magnetic compressive anastomosis can realize the fast anastomosis, reduce the difficulty, and reduce the incidence of anastomotic leakage and stricture. Currently, the majority of studies of magnetic compressive bilioenteric anastomosis are merely confined within clinical case report and single-center, small sample, retrospective study. This study is a prospective, randomized controlled trial. To evaluate the security, reliability and convince of magnetic compressive bilioenteric anastomosis versus traditional suture method on incidence of anastomotic leakage and stricture between magnetic compressive anastomosis and traditional manual anastomosis among patients who need bilioenteric anastomosis operation. The study is to enroll about 200 patients and divide into Study Group (Group A: Magnetic compressive anastomosis) and Control Group (Group B: traditional manual anastomosis) as 1:1 ratio randomly by stratification factors. The incidence of anastomotic leakage and stricture, length of bilioenteric anastomosis time, value of serum bilirubin, length of discharge time of magnetic device and mean time of hospital stay will be evaluated. The patients will drop out of the study if adverse events happen, active request for dropping out, new-onset severe disease or death. The primary and secondary end point will be observed by regular follow-up.
Exclusion Criteria:
Child-Pugh C with hepatic encephalopathy Anyone with heart, lung, kidney dysfunction or other organ dysfunction, and cannot tolerate surgery.Hepatic ducts stone disease, who was diagnosed as Acute Cholangitis of Severe Type, especially complicated with bacteremia or septic shock. End stage disease, complicated with biliary cirrhosis or portal hypertension.Patients with long- term obstructive jaundice, dehydration, electrolyte disturbance or coagulation defects; Patients have the tendency or history of bleeding.
A magnetic device will be used during bilioenteric anastomosis.
Procedure: Magnetic Compressive Anastomosis
A handsewn technique will be used during bilioenteric anastomosis.
Procedure: Manual Anastomosis
The magnetic compressive anastomosis will be used to complete the anastomosis during bilioenteric anastomosis.
A handsewn technique will be used to complete the anastomosis during bilioenteric anastomosis.
Bilioenteric anastomotic leakage
To compare the incidence of biliary leakage after magnetic or hand-sewn anastomosis
Time frame: 1 month post operation
Length of bilioenteric anastomosis time
To compare the anastomotic time between magnetic and hand-sewn groups
Time frame: during operation
Time from the date of operation to expel of the magnets.
To confirm the safe discharge of the magnets
Time frame: 1 to 4 weeks postoperation
average length of postoperative hospital stay
To compare the length of stay between magnetic and hand-sewn groups
Time frame: 3 months
Bilioenteric anastomotic stricture
To compare the long-term outcome between magnetic and hand-sewn groups
Time frame: 1,3,6,12-month post operation
Plan to share: Undecided
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First Affiliated Hospital Xi'an Jiaotong University