Chronic PancreatitisPASTECNCT02366988
The PASTEC Study: Endoscopic Stenting Versus Surgery for the Treatment of Bile Duct Stricture in Chronic Pancreatitis
A study testing Endoscopic Biliary Stenting and Surgical treatment Bilio-enteric anastomosis in people with Chronic Pancreatitis, run by University Hospital, Lille at 7 sites in France.
Trial summary
Biliary obstruction complicates the course of chronic pancreatitis in 3%-23% of patients and in these cases, endoscopy and surgery are the treatment modalities of choice. Morbid-mortality of these procedures is similar and physicians face the decision between endoscopy and surgery for this group of patients, with no… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Chronic Pancreatitis
- What is being tested?
- Endoscopic Biliary Stenting and Surgical treatment Bilio-enteric anastomosis
- Type of treatment
- Medical device, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 7 participants
- Where
- 7 sitesFrance
- Study dates
- Feb 2015to Jun 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Clinical symptomatic chronic pancreatitis-related biliary duct stricture (pain or jaundice or pale stool / dark urine)
- Biological symptomatic chronic pancreatitis-related biliary duct stricture (elevation of serum alkaline phosphatase (>2 or 3 times the upper limit of normal values) and/or of serum bilirubin for longer than 1 month)
- Isolated biliary stricture or biliary stricture associated to main pancreatic duct stricture
- Secondary biliary cirrhosis
- Progression of biliary stricture
Who cannot join
- Pancreatic malignancy
- Cirrhosis
- Portal vein thrombosis, portal cavernoma
- Primary sclerosing cholangitis
- Recent acute pancreatitis (i.e., in the previous 3 weeks)
- Acute hepatitis
Show all 15Show fewer
- Post-surgical biliary stricture
- Biliary stones or pseudocyst-related biliary duct stricture
- Previous pancreatic surgery or endoscopic sphincterotomy
- Score IV or V on the American Society of Anesthesiologists scale
- Pregnancy or breastfeeding
- Patient aged under 18 yrs
- Emergency clinical situations (i.e., angiocholitis with septicemia)
- Non-compliant patients or suffering from legal incapacity
- Contra-indication for endoscopic or surgical treatment
Trial locations and contacts
7 sites in 1 country.
7 sites in 1 country
France7 sites
Centre hospitalier
Béthune
Centre hospitalier
Dunkirk
Centre Hospitalier Dr Schaffner
Lens
Clinique de la Louvière
Lille
Hôpital St Philibert
Lomme
Centre hospitalier
Roubaix
Centre hospitalier
Valencienne
About this study
Official title: Phase 3 Prospective, Multicentric Randomized Study of Endoscopic Versus Surgical Treatment of Bile Duct Stricture in Chronic Pancreatitis
Biliary obstruction complicates the course of chronic pancreatitis in 3%-23% of patients and in these cases, endoscopy and surgery are the treatment modalities of choice. Morbid-mortality of these procedures is similar and physicians face the decision between endoscopy and surgery for this group of patients, with no randomized controlled trial available comparing these procedures.
The PASTEC trial is a multicenter, phase III, randomized, comparing the effectiveness of surgical and endoscopic interventions in the management of bile duct stricture for chronic pancreatitis.
The primary end point is 18-months normalization of serum alkaline phosphatase. Secondary end points are morbid-mortality rate, quality of life, numbers of endoscopic or surgical procedures, length of stay. Eighty-six patients need to be included.
Read the detailed description
This study is planned to last for 4 years, with a 2-year inclusion period and a 2-year follow-up period.
- Conditions
- Chronic Pancreatitis
- Being tested
- Endoscopic Biliary Stenting, Surgical treatment Bilio-enteric anastomosis
- Keywords
- Chronic pancreatitis, Clinical Trial, Bile stricture, Endoscopy, Surgery
- Medical subject headings
- Pancreatitis, Chronic
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Endoscopic Biliary StentingDevice
Endoscopic probe self-expandable metallic covered stent Biliary stent will be left in place for 6 months
Surgical treatment Bilio-enteric anastomosisProcedure or surgery
Bilio-enteric anastomosis including Whipple, Frey or Beger procedure, double or triple derivation
| Study group | Role | What they receive |
|---|---|---|
| Endoscopic Biliary Stenting | Active comparator | Temporary self-expandable metallic covered stent Receives: Device: Endoscopic Biliary Stenting |
| Surgical treatment | Active comparator | Bilio-enteric anastomosis including Whipple, Frey or Beger procedure, double or triple derivation Receives: Procedure: Surgical treatment Bilio-enteric anastomosis |
What is being measured
The primary outcome is the main question the study is designed to answer.
normalization of serum alkaline phosphatase (considered as < 130 UI/L)
A normal value of serum alkaline phosphatase will be considered as < 130 UI/L
Measured: 18 months
Secondary outcomes (14)
Quality of Life (EORTC health surveys)
EORTC health surveys will administered to assess quality of life.
Measured: At 18 months
abdominal pain (Clinical symptoms assessed by Izbicki's score)
Clinical symptoms assessed by Izbicki's score,
Measured: at 1, 3, 6, 12,18 months after the procedure
jaundice, (Clinical symptoms assessed)
Clinical symptoms assessed
Measured: at 1, 3, 6, 12,18 months after the procedure
pruritus, (Clinical symptoms assessed)
Clinical symptoms assessed
Measured: at 1, 3, 6, 12,18 months after the procedure
pale stool, (Clinical symptoms assessed)
Clinical symptoms assessed
Measured: at 1, 3, 6, 12,18 months after the procedure
dark urine. (Clinical symptoms assessed)
Clinical symptoms assessed
Measured: at 1, 3, 6, 12,18 months after the procedure
Cholestasis
Biological measures Cholestasis Bilirubinemia < 1,2 mg/dl (norms : 0,1 à 1,2 mg / dl) Gamma GT < 50 UI / L
Measured: At 1, 3, 6, 12, 18 months after the procedure
Cytolysis
Biological measures Cytolysis TGO < 40 UI / L (norms : 15 à 40 UI / L) TGP < 40 UI / L (norms : 10 à 40 UI / L)
Measured: At 1, 3, 6, 12, 18 months after the procedure
Liver failure
Biological measures Liver failure TP > 60% (norms : 60 à 120%) Facteur V > 60% (norms : 60 à 120%)
Measured: At 1, 3, 6, 12, 18 months after the procedure
CT-Scan (Morphological assessment)
Morphological assessment by CT-Scan, Pseudocyst, main pancreatic duct > 3 mm, inflammatory cephalic mass > 4 cm, biliary duct stricture, pancreatic calcifications
Measured: At 6 and 18 months after the procedure
Bili-MRI
Morphological assessment by Bili-MRI, Pseudocyst, main pancreatic duct > 3 mm, inflammatory cephalic mass > 4 cm, biliary duct stricture, pancreatic calcifications
Measured: At 6 and 18 months after the procedure
presence of surgical complications ( dindo and Clavien )
Measured: At 1, 3, 6, 12, 18 months
Hospital length of stay
Measured: At 1, 3, 6, 12, 18 months
number of re - hospitalization
Measured: At 1, 3, 6, 12, 18 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Feb 2015 (estimated)
- Study startFeb 2015
- Primary completionJun 2018
- Study completionJun 2018
Why it stopped: sponsor decision: not enough inclusion
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Chronic PancreatitisStudies of the same condition, open and under way.
- More trials run by University Hospital, LilleThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 7 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Hospital, Lille
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Philippe ZERBIB, MD, PhD, Study chair, University Hospital, Lille
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02366988
- Sponsor's protocol ID
- 2012_43
- Other IDs
- 2013-A01671-44
- Acronym
- PASTEC
- Status last verified
- Jun 2018
- First submitted
- 24 Sep 2014
- Last updated
- 21 Jun 2018
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 21 Jun 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase 3 Prospective, Multicentric Randomized Study of Endoscopic Versus Surgical Treatment of Bile Duct Stricture in Chronic Pancreatitis
- ClinicalTrials.gov ID
- NCT02366988
- Acronym / sponsor ID
- PASTEC / 2012_43
- Conditions
- Chronic Pancreatitis
- Keywords
- Chronic pancreatitis, Clinical Trial, Bile stricture, Endoscopy, Surgery
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: sponsor decision: not enough inclusion
- Enrolment
- 7 participants (actual)
- Lead sponsor
- University Hospital, LilleUniversity, hospital or other
- Study start
- Feb 2015
- Primary completion
- Jun 2018 (actual)
- Study completion
- Jun 2018 (actual)
- First posted
- 20 Feb 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Biliary obstruction complicates the course of chronic pancreatitis in 3%-23% of patients and in these cases, endoscopy and surgery are the treatment modalities of choice. Morbid-mortality of these procedures is similar and physicians face the decision between endoscopy and surgery for this group of patients, with no randomized controlled trial available comparing these procedures.
The PASTEC trial is a multicenter, phase III, randomized, comparing the effectiveness of surgical and endoscopic interventions in the management of bile duct stricture for chronic pancreatitis.
The primary end point is 18-months normalization of serum alkaline phosphatase. Secondary end points are morbid-mortality rate, quality of life, numbers of endoscopic or surgical procedures, length of stay. Eighty-six patients need to be included.
Detailed description
This study is planned to last for 4 years, with a 2-year inclusion period and a 2-year follow-up period.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Endoscopic Biliary Stenting | Active comparator | Device: Endoscopic Biliary StentingTemporary self-expandable metallic covered stent |
| Surgical treatment | Active comparator | Procedure: Surgical treatment Bilio-enteric anastomosisBilio-enteric anastomosis including Whipple, Frey or Beger procedure, double or triple derivation |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Clinical symptomatic chronic pancreatitis-related biliary duct stricture (pain or jaundice or pale stool / dark urine)
- Biological symptomatic chronic pancreatitis-related biliary duct stricture (elevation of serum alkaline phosphatase (>2 or 3 times the upper limit of normal values) and/or of serum bilirubin for longer than 1 month)
- Isolated biliary stricture or biliary stricture associated to main pancreatic duct stricture
- Secondary biliary cirrhosis
- Progression of biliary stricture
Key exclusion criteria (15 listed)
- Pancreatic malignancy
- Cirrhosis
- Portal vein thrombosis, portal cavernoma
- Primary sclerosing cholangitis
- Recent acute pancreatitis (i.e., in the previous 3 weeks)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Endoscopic Biliary StentingEndoscopic probe self-expandable metallic covered stent Biliary stent will be left in place for 6 months | Device | Endoscopic Biliary Stenting |
| Surgical treatment Bilio-enteric anastomosisBilio-enteric anastomosis including Whipple, Frey or Beger procedure, double or triple derivation | Procedure or surgery | Surgical treatment |
Primary outcome
normalization of serum alkaline phosphatase (considered as < 130 UI/L)
Time frame: 18 months
A normal value of serum alkaline phosphatase will be considered as < 130 UI/L
14 secondary outcomes
Quality of Life (EORTC health surveys)
Time frame: At 18 months
abdominal pain (Clinical symptoms assessed by Izbicki's score)
Time frame: at 1, 3, 6, 12,18 months after the procedure
jaundice, (Clinical symptoms assessed)
Time frame: at 1, 3, 6, 12,18 months after the procedure
pruritus, (Clinical symptoms assessed)
Time frame: at 1, 3, 6, 12,18 months after the procedure
pale stool, (Clinical symptoms assessed)
Time frame: at 1, 3, 6, 12,18 months after the procedure
dark urine. (Clinical symptoms assessed)
Time frame: at 1, 3, 6, 12,18 months after the procedure
Cholestasis
Time frame: At 1, 3, 6, 12, 18 months after the procedure
Cytolysis
Time frame: At 1, 3, 6, 12, 18 months after the procedure
Liver failure
Time frame: At 1, 3, 6, 12, 18 months after the procedure
CT-Scan (Morphological assessment)
Time frame: At 6 and 18 months after the procedure
Bili-MRI
Time frame: At 6 and 18 months after the procedure
presence of surgical complications ( dindo and Clavien )
Time frame: At 1, 3, 6, 12, 18 months
Hospital length of stay
Time frame: At 1, 3, 6, 12, 18 months
number of re - hospitalization
Time frame: At 1, 3, 6, 12, 18 months
Results and safety
The study was stopped early (reason given: sponsor decision: not enough inclusion). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Jun 2018.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Philippe ZERBIB, MD, PhD study chair
University Hospital, Lille
7 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Endoscopic Biliary Stenting and Surgical treatment Bilio-enteric anastomosis in people with Chronic Pancreatitis, run by University Hospital, Lille at 7 sites in France.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 21 Jun 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 7 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study was stopped early (reason given: sponsor decision: not enough inclusion). Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
normalization of serum alkaline phosphatase (considered as < 130 UI/L) (time frame: 18 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Jun 2018.