NCT05261997

Brief Summary

This is a prospective randomized controlled trial. . Patients will be divided into conservative or endoscopic group and fecal pancreatic elastase-1 (FE-1) is tested to evaluate pancreatic exocrine function. The effect of extracorporeal shock wave lithotripsy and endoscopic treatment on the progression of chronic pancreatitis in painless patients will be determined.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
60

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Mar 2022

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 24, 2021

Completed
3 months until next milestone

Study Start

First participant enrolled

March 1, 2022

Completed
1 day until next milestone

First Posted

Study publicly available on registry

March 2, 2022

Completed
1.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 1, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 1, 2023

Completed
Last Updated

March 2, 2022

Status Verified

February 1, 2022

Enrollment Period

1.7 years

First QC Date

November 24, 2021

Last Update Submit

February 26, 2022

Conditions

Keywords

chronic pancreatitisendoscopic retrograde cholangiopancreatographyExocrine Pancreatic Insufficiencypainless

Outcome Measures

Primary Outcomes (1)

  • exocrine function of the pancreas assessed by the value of fecal elastase in μg/g

    Pancreatic exocrine function insufficiency(PEI) is defined as fecal elastase \<200 μg/g. The result wii be divided into 4 conditions, including normal exocrine function, newly developed PEI, PEI relief, PEI persisting.

    12 months

Secondary Outcomes (4)

  • endocrine function of the pancreas assessed by glycosylated hemoglobin in %.

    12 months

  • endocrine function of the pancreas assessed by fasting blood glucose in mmol/L

    12 months

  • endocrine function of the pancreas assessed by fasting C peptide in ug/L

    12 months

  • life quality assessed by SF-36 questionnaire

    12 months

Other Outcomes (2)

  • BMI in kg/m^2

    12 months

  • Treatment-related costs in RMB from initial enrollment to the end of the study

    12 months

Study Arms (2)

Endoscopic group

EXPERIMENTAL

The patients received intravenous analgesia (flurbiprofen and remifentanil) before the ESWL (Compact Delta II; Dornier Med Tech, Wessling, Germany). After the last ESWL session, the patients are treated with following ERCP within 48h. ERCP was performed under conscious sedation with intramuscular administration of diazepam 2.5-5.0 mg and pethidine 25-50 mg. If necessary, endoscopic sphincterotomy was performed. A dilating bougie or balloon will be used to dilate the stenosis after sphincterotomy. Standard techniques (i.e., extraction basket, extraction balloon, or both) will be used for stone removal. A pancreatic duct stent for drainage and nasopancreatic catheters will be inserted for temporary drainage if necessary. Conservative treatments similar to patients in the control group were given in endoscopic group according to patients' condition.

Procedure: extracorporeal shock wave lithotripsy and endoscopic drainage of the main pancreatic duct

Conservative group

OTHER

Patients will have pancreatic enzymes (Pancreatin Enteric-coated Capsules or Oryz-Aspergillus Enzyme and Pancreatin Table) to control symptoms of exocrine pancreatic insufficiency. The recommended initial dose for adults is (25 000-40 000) IU lipase per meal (40 000 IU for meals and 20 000 IU for snacks), which can be increased until the PEI is relieved. The maximum recommended dose is (75 000-80 000) IU lipase per meal. Actions including drugs(Acarbose Tablets, Glucophage, Glimepirde Tablets) or insulin(Biosynthetic Human Insulin Injection, Tresiba or both) would also be taken for control of diabetes according to patients' glucose levels.

Drug: pancreatic enzyme(Pancreatin Enteric-coated Capsules or Oryz-Aspergillus Enzyme and Pancreatin Table), antidiabetic medicine(Acarbose Tablets, Glucophage, Glimepirde Tablets)

Interventions

In addition to drug administrated in the control group, patients in this group would be treated with ESWL and endoscopic drainage of the main pancreatic duct.

Also known as: ESWL, ERCP
Endoscopic group

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • diagnosed with chronic pancreatitis without pain attack related with chronic pancreatitis;
  • calcified stone in the cephalic or corporeal portion of the main pancreatic duct with upstream duct dilation;
  • no ERCP or ESWL carried out before admission;

You may not qualify if:

  • suspected to have malignant tumors;
  • history of pancreatic surgery or gastrojejunostomy (Billroth II);
  • with end-stage disease;
  • pregnancy or lactation;
  • refuse to write informed consent

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Changhai Hospital

Shanghai, 200433, China

RECRUITING

MeSH Terms

Conditions

Pancreatitis, ChronicExocrine Pancreatic InsufficiencyAbdominal Pain

Interventions

LithotripsyCholangiopancreatography, Endoscopic RetrogradeMetformin

Condition Hierarchy (Ancestors)

PancreatitisPancreatic DiseasesDigestive System DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and SymptomsPainNeurologic ManifestationsSigns and SymptomsSigns and Symptoms, Digestive

Intervention Hierarchy (Ancestors)

TherapeuticsUltrasonic Surgical ProceduresSurgical Procedures, OperativeCholangiographyRadiography, AbdominalRadiographyDiagnostic ImagingDiagnostic Techniques and ProceduresDiagnosisDiagnostic Techniques, Digestive SystemEndoscopy, Digestive SystemEndoscopyDiagnostic Techniques, SurgicalDigestive System Surgical ProceduresMinimally Invasive Surgical ProceduresBiguanidesGuanidinesAmidinesOrganic Chemicals

Study Officials

  • Zhuan Liao, MD

    Shanghai Changhai Hospital, Shanghai, China

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Patients will be divided into conservative treatment group or endoscopic treatment group.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Clinical Professor

Study Record Dates

First Submitted

November 24, 2021

First Posted

March 2, 2022

Study Start

March 1, 2022

Primary Completion

November 1, 2023

Study Completion

November 1, 2023

Last Updated

March 2, 2022

Record last verified: 2022-02

Data Sharing

IPD Sharing
Will not share

Locations