Cholelithiasis Associated With Common Bile Duct Stones
Conditions
Keywords
cholelithiasis, laparoscopic cholecystectomy, endoscopic sphincterotomy, choledocholithiasis
Brief summary
Timing of laparoscopic cholecystectomy following after endoscopic retrograde cholangiography for acute biliary pancreatitis is a controversial issue. There are still many confounding findings offering either early laparoscopic cholecystectomy within 72 hours following endoscopic sphincterotomy or delayed surgery after 6 weeks. Peritoneal plasmin system is known to be an important factor in peritoneal healing and adhesion formation. Measurement of tissue concentrations of tissue-type plasminogen activator and its specific activity, urokinase-type plasminogen activator, and plasminogen activator inhibitor type 1 are thought to be helpful to show peritoneal adhesions after endoscopic sphincterotomy.
Detailed description
Peritoneal fibrinolysis is crucial in peritoneal healing processes and subsequent adhesion formation. It is expected that endoscopic retrograde cholangiography is a trauma causing adhesions around the hepatobiliary area. Such adhesions may cause some difficulty for consequent gallbladder surgery. For that reason, tissue measurements of factors indicating degree of peritoneal healing and adhesion is helpful for timing of such surgical interventions. Patients are going to be randomized to early and delayed surgery groups. Sampling of peritoneum around the gallbladder during laparoscopic cholecystectomy in patients after endoscopic retrograde cholangiography is performed. Tissue concentrations of tissue-type plasminogen activator and its specific activity, urokinase-type plasminogen activator, and plasminogen activator inhibitor type 1 are going to be studied by using commercial assays. Peritoneal fibrinolytic activity and surgical outcomes are going to be compared.
Interventions
OTHERtissue sampling from peritoneum of the gallbladder
tissue sampling from peritoneum of the gallbladder during laparoscopic cholecystectomy after an acute attack of acute biliary pancreatitis
Sponsors
Bezmialem Vakif University
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* cholelithiasis following endoscopic retrograde cholangiography for acute biliary pancreatitis
Exclusion criteria
* contraindication to laparoscopy * unsuccessful endoscopic retrograde cholangiography * complicated acute biliary pancreatitis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| measurement of peritoneal fibrinolytic response following endoscopic retrograde cholangiography | six months | measurement of tissue concentrations of tissue-type plasminogen activator and its specific activity, urokinase-type plasminogen activator , and plasminogen activator inhibitor type 1 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| surgical outcomes of laparoscopic cholecystectomy following endoscopic retrograde cholangiography | six months | evaluation of surgical outcomes including operating time, morbidity and mortality of laparoscopic cholecystectomy |
Countries
Turkey (Türkiye)
Outcome results
None listed