Peptic Ulcer Clinical Trial
Official title:
Feasibility of Translumenal Endoscopic Omental Patch Closure of Perforated Viscus
This study is being done to see if a new approach to repair perforated ulcers in the stomach
(holes in the stomach) or the first part of the intestine is possible. Traditionally, either
open operations (large single incision) or laparoscopic operations (multiple small
camera-guided incisions) have been used to repair perforated ulcers. Over the last ten
years, some surgeons have used endoscopic equipment to assist them with performing the
procedure. It is unknown if perforated ulcer repair can be done using an endoscope as the
main instrument (a flexible tube with a video camera inserted into the stomach through your
esophagus) to "patch" or plug the perforation. We will patch the perforation using a
standard method which uses tissue from outside the stomach. A laparoscopic camera will also
be used to assist our view. This study is intended to be a feasibility study to demonstrate
the endoscopic technique can be safely performed
Hypothesis: The primary outcome is successful completion of the procedure.
Perforation is the most dangerous complication of gastroduodenal ulcer disease. It accounts
for more than 70% of deaths associated with peptic ulcer disease. In addition to age and
concomitant disease, intervention related complications are statistically significant
predictors of death after hospital stay. Age, time to presentation and comorbidities are not
factors that can be influenced. If it would be possible to reduce the impact of procedure
related complications or the "second hit", that may lead to decreased morbidity and
mortality.
This will be a pilot clinical study to evaluate the safety and feasibility of endoscopic
translumenal omental patch closure. Patients with the clinical diagnosis of a perforated
viscus who are scheduled to undergo surgical exploration will be recruited. Endoscopic
translumenal omental patch will be attempted first if the patient has no contraindication.
Should this prove unsuccessful, the surgical team will proceed with conversion to
laparoscopic or open standard surgical therapy as indicated.
;
Intervention Model: Single Group Assignment, Masking: Open Label
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