Neoplasms

Digestive System Diseases

All Conditions

Symptoms and General Pathology

Rare Diseases

Gallbladder Neoplasms

Gallstones

Cholecystitis

Acalculous Cholecystitis

Cholelithiasis

Cholecystolithiasis

Incidental gallbladder cancer and other pathology

Histopathological result

Ufuk Uylas

Causes such as long-term stones and polyp are thought to play a role in the etiology of gallbladder cancer. The routine histopathological examination provides the detection of incidental gallbladder cancers. It should be remembered that acute or chronic cholecystitis accompanied by the thicked wall and a prolonged history of gallstones may be the cause of malignancy, especially in elderly patients.

The investigators aimed to incidental gallbladder cancer and compare other pathology results with elderly patients.

Incidental Cancer in Gallbladder Surgical Specimens Focus on Elderly Patients

Incidental Cancer in Gallbladder Surgical Specimens Focus on Elderly Patients, Retrospective Analysis of 2389 Patients

Number of Participants with adenocarcinom

Dr. Ersin Arslan Education and Training Hospital

Specialist

Wounds and Injuries

Gallbladder Diseases

Biliary Tract Diseases

Gastrointestinal Diseases

Biliary Tract Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Calculi

Pathological Conditions, Anatomical

Gallbladder Cancer

Central Nervous System Depressants

All Drugs and Chemicals

Ropivacaine

Anesthetics

Anesthetics, Local

Local ropivacaine infiltration + laparoscopically controlled TAP (transversus abdominis plane block). Daycare patients.

Local ropivacaine infiltration only. Daycare patients.

Local ropivacaine infiltration + laparoscopically controlled TAP. In-patient surgery.

Local ropivacaine infiltration only. In-patient surgery.

Local ropivacaine infiltration + laparoscopically controlled TAP. Emergency patients.

Local ropivacaine infiltration only. Emergency patients.

single transversus abdominis laparoscopy-guided plane block

local trocar site ropivacaine infiltration

Roman Kornõšev, MD

Alexey Schramko, MD, PhD, Doc

Roman Kornõšev

Alexey Schramko, PhD, Doc

Henna Sammalkorpi, MD, PhD

Hanna Lampela, MD, PhD

Jukka Harju, MD, PhD, Doc

This trial is a prospective randomized superiority trial comparing sole ropivacaine based local trocar site infiltration to local infiltration combined with laparoscopic ropivacaine TAP block (STALL) in LCC.

There are only a few randomized trials comparing sole local anesthesia to additional laparoscopic TAP block in laparoscopic cholecystectomy and they have yet failed to show evidence in favor of TAP block.

We hypothesize STALL (Single Transversus Abdominis Laparoscopy-guided plane block combined with Local trocar site ropivacaine infiltration) is superior to local port site infiltration, provided that the sample size is sufficiently big.

The aim of this randomized study is to compare the efficacy of sole local anesthesia of trocar sites to STALL in LCC.

Patients are analyzed following the intention to treat in three subgroups:

1. Patients treated in "day-care" outpatient surgical unit (DS): TAP+local vs local.
2. Patients treated electively in the inpatient surgery unit (IS): TAP+local vs local.
3. Emergency surgery patients (ES): TAP+local vs local.

The study will be blinded to patients and recovery room personnel, as well as the ward nurses and physicians, but not to operating surgeon(s), anesthesiologist(s), and nurses, treating patients during the surgery.

STALL vs Sole Local Wound Infiltration in Laparoscopic Cholecystectomy

Single Transversus Abdominis Laparoscopy-guided Plane Block Combined With Local Trocar Site Ropivacaine Infiltration (STALL) vs Sole Local Wound Infiltration in LCC (Laparoscopic CholeCystectomy) - Double-blinded Randomized Controlled Trial.

min, (= "patient ready to be discharged" timestamp OR "patient ready for transfer")

TAP + port site infiltration complications (as per trial plan) + other complications according to Clavien-Dindo classification

using questionnaires, multiple timepoints: recovery stay, hospital stay, discharge, feedback after 7 days

APS (acute pain service) contact, admission of DS subgroup patient to the ward due to pain, failure to discharge

Helsinki University Central Hospital

Cholangiocarcinoma

Constriction, Pathologic

Choledocholithiasis

Adenocarcinoma

Carcinoma

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Bile Duct Diseases

Common Bile Duct Diseases

Bile Duct Cancer

Per standard treatment protocol for percutaneous cholangiopancreatoscopy, access will be gained into the biliary system using the biliary tube or into the gallbladder using the cholecystostomy tube. After access has been secured, through a peel-away sheath a Spy Glass Discover Digital Catheter will be introduced. Next, either, the stones will then be removed from the biliary system or gallbladder using a combination of baskets, and lithotripsy equipment as required, or in case of biliary strictures, a clamshell biopsy will be taken from the stricture site as identified on endoscopic visualization and cross-sectional imaging. Further intervention maybe performed for the stricture based on operator preference. After the complete stone removal/ stricture management the cholecystostomy/ biliary tube will be removed after the patient passes a clinical capping trial.

Percutaneous cholangiopancreatoscopy

Harjit Singh, MD

Hannatu Bwayili, BS

Tushar Garg, MD

The Percutaneous Cholangiopancreatoscopy (PCPS) registry is an observational, multicentric, prospective, and retrospective registry of patients undergoing the percutaneous cholangiopancreatoscopy procedure at sites across the United States. In the retrospective component of the study, clinical and procedural data regarding patients who have undergone clinical indicated percutaneous cholangiopancreatoscopy procedure in the past will be collected from all the registry sites and stored in a secure database. The prospective component of the registry will run for three years at each site where patients undergoing the clinically indicated percutaneous cholangiopancreatoscopy procedure will be enrolled in the study, and the patients' data will be collected whenever the patients present to interventional radiology (IR) for a procedure or clinic visit.

Percutaneous Cholangiopancreatoscopy Registry

The Percutaneous Cholangiopancreatoscopy Registry

Tube free survival will be calculated by estimating the number of patients who can undergo removal of the biliary/ cholecystostomy tube after the PCPS procedure until their last IR clinical follow-up or death.

Technical success is defined as successful access with cholangioscope and visualization of the stones or a lesion to be biopsied.

Procedural success in patients with calculi, is defined as either a) visualization of stones with at least partial stone removal, or b) visualization of biliary system demonstrating no need for further investigation; in patients with biliary stricture, defined as a) obtaining tissue for biopsy or b) successfully visualize and complete or partial treatment of the stricture.

Clinical success is defined as improvement in clinical symptoms (e.g., abdominal pain, fever, jaundice, nausea and vomiting), laboratory values and/or imaging findings.

Complication rate will be calculated by recording the adverse events that occur during the procedure in accordance with the Society of Interventional Radiology Classification System.

Complication rate will be calculated by recording the adverse events that occur after the procedure in accordance with the Society of Interventional Radiology Classification System.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Incidental Cancer in Gallbladder Surgical Specimens Focus on Elderly Patients	NCT04352478	Pathology	Histopathologic...	-	Dr. Ersin Arslan Education and Training Hospital
STALL vs Sole Local Wound Infiltration in Laparoscopic Cholecystectomy	NCT06123117	Cholelithiasis Cholecystitis Gallbladder Can...	single transver... local trocar si...	18 Years -	Helsinki University Central Hospital
Percutaneous Cholangiopancreatoscopy Registry	NCT05210322	Biliary Stones Cholangiocarcin... Biliary Strictu... Cholelithiasis Choledocholithi...	Percutaneous ch...	18 Years -	Johns Hopkins University
STALL vs Sole Local Wound Infiltration in Laparoscopic Cholecystectomy	NCT06123117	Cholelithiasis Cholecystitis Gallbladder Can...	single transver... local trocar si...	18 Years -	Helsinki University Central Hospital
Percutaneous Cholangiopancreatoscopy Registry	NCT05210322	Biliary Stones Cholangiocarcin... Biliary Strictu... Cholelithiasis Choledocholithi...	Percutaneous ch...	18 Years -	Johns Hopkins University
Percutaneous Cholangiopancreatoscopy Registry	NCT05210322	Biliary Stones Cholangiocarcin... Biliary Strictu... Cholelithiasis Choledocholithi...	Percutaneous ch...	18 Years -	Johns Hopkins University

Spots Global Cancer Trial Database for cholelithiasis