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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT06223061
Other study ID # GlobalSurg 4 Edinburgh
Secondary ID
Status Active, not recruiting
Phase
First received
Last updated
Start date July 31, 2023
Est. completion date November 1, 2024

Study information

Verified date January 2024
Source University of Edinburgh
Contact n/a
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Cholecystectomy is amongst the most common surgical operations performed worldwide. Surgical candidates are treated for biliary pathologies, such as biliary colic, cholecystitis and gallstone pancreatitis. In patients who are deemed fit for surgery, cholecystectomy can be performed under three main settings: (1) emergency setting at index admission; (2) elective setting with no previous admissions; or (3) delayed setting with one or more previous gallbladder-related admissions. The advent of laparoscopy fundamentally evolved biliary surgery and quickly became the "gold standard" approach. Recent multicentre collaborative studies have elucidated that the burden imposed on healthcare systems by laparoscopic cholecystectomies is primarily due to patient readmissions and complications arising from the operation, rather than perioperative mortality burden that was more commonly seen in open surgery. As a result, national and international societies have shifted their focus towards creating a culture of safety around this procedure, with the overarching goal of improving patient satisfaction and reducing hospital costs. The universal establishment of safe cholecystectomy is a complex process that relies not only on the operation itself, but also on various other factors such as promoting adequate training, improving hospital infrastructure, and enhancing perioperative patient care. There remains a paucity of evidence around the variations of safe provision of laparoscopic surgery for gallbladder disease internationally, including low- and middle-income countries. To bridge this knowledge gap, the Global Evaluation of Cholecystectomy Knowledge and Outcomes (GECKO) study (GlobalSurg 4) will be an international collaborative effort, delivered by the GlobalSurg network, that will allow contemporaneous data collection on the quality of cholecystectomies using measures covering infrastructure, care processes and outcomes. It will be disseminated via contacts from the National Institute for Health and Care Research (NIHR) Global Surgery unit, leading emergency general surgeons and specialist organisations.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 30000
Est. completion date November 1, 2024
Est. primary completion date November 19, 2023
Accepts healthy volunteers
Gender All
Age group 18 Years to 100 Years
Eligibility Inclusion Criteria: - Age: All adult patients (greater than or including 18 years of age). - Procedure: Primary cholecystectomy, where this is the main procedure planned. - Approach: Open, laparoscopic (standard and single-port), and robotic. Gasless laparoscopic and robotic approaches are inluded. Laparoscopic and robot converted cases are also eligible. - Urgency: Elective, delayed and emergency procedures. Exclusion Criteria: - Procedure: Patients having a cholecystectomy as a part of another surgical procedure; for example, Whipple's procedure, bariatric, anti-reflux, or transplant operations, should be excluded. - Indication: Patients with Mirizzi syndrome should be excluded. - Return to theatre: Each patient should only be entered into the study once. Any patient returning to theatre and requiring a cholecystectomy for whatever indication, should not be included. - Known gallbladder malignancy: when the diagnosis of gallbladder cancer is established pre-operatively, the patient should be excluded. However, if gallbladder cancer is found unexpectedly during or after cholecystectomy (i.e. on histology), the patient should be included.

Study Design


Locations

Country Name City State
United Kingdom University of Edinburgh Edinburgh

Sponsors (2)

Lead Sponsor Collaborator
University of Edinburgh University of Birmingham

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary Compliance to pre-, intra-, and post-operative audit standards Compliance to audit standards are defined as follows:
Pre-operative: For patients with acute cholecystitis, surgeons may use the Tokyo Guidelines 18.
Intraoperative: The use of the critical view of safety during laparoscopic cholecystectomy is the recommended approach to correctly identify relevant anatomy and minimize the risk of bile duct injuries
Postoperative: 30-day readmission should be <10%.
30-days from surgery
Secondary Quality of provision of cholecystectomy The quality will be assessed according to the rates of overall complications defined as the presence of Grade I to grade V Clavien-Dindo complication. 30-days of surgery
Secondary Adverse events following cholecystectomy (e.g., bile duct injury) and their management. Occurence of bile duct injury within 30-days of surgery will be defined according to the Strasberg Classification 30-days of surgery
Secondary Rates of unsuspected gallbladder cancer. The rates of gallbladder cancer will be assessed at 1-year from the index surgery once the histology results are available. 1-year from surgery
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