Intravenous Human Albumin In Improving Pancreaticoduodenectomy Outcomes

  • STATUS
    Recruiting
  • End date
    Nov 26, 2022
  • participants needed
    122
  • sponsor
    Universiti Kebangsaan Malaysia Medical Centre
Updated on 20 October 2021
cancer
pancreaticoduodenectomy
human albumin
periampullary adenocarcinoma
Accepts healthy volunteers

Summary

Pancreaticoduodenectomy (PD), more commonly known as Whipple's surgery is the mainstay treatment for pancreatic head and periampullary cancer. Factors contributing to PD outcomes are broadly categorized to disease-related, patient-related and operative factors. Whereas an inexhaustible list of study exists on looking at reducing PD complication rates with respect to the above-mentioned factors, it was only recently that more attention has been given to the impact of perioperative and intraoperative fluid regimes on PD outcomes. This study takes interest in the impact of intraoperative fluid regimes on PD outcomes. The objective of this investigation is to compare the outcomes with the use of intraoperative intravenous human albumin versus standard intraoperative fluid regimes.

Description

This is a randomized controlled trial being conducted at the Universiti Kebangsaan Malaysia Medical Center (UKMMC) with two arms; the control and treatment arms. The treatment arm will receive intravenous human albumin intraoperatively whilst the control arm will receive standard intraoperative fluid regimes. Primary endpoint will be overall complication rates whilst secondary endpoints are length of hospitalization, length of ICU care, duration of gastroparesis, pancreatic fistula rates, surgical site infection rates, duration of surgery and intraoperative bleeding.

Beyond the intraoperative fluid regimes, postoperative care follows the standardised UKMMC Enhanced Recovery After Surgery (ERAS) protocols which saw an improvement in overall outcomes in patients who underwent pancreaticoduodenectomies (PD). Preoperative care will include nutrition optimisation, counselling, antimicrobial prophylaxis, perioperative glycemic control and near-zero fluid balance.

Data collection will include:

i. preoperative data: age, sex, ethnicity, BMI on admission, date of admission, comorbidities and the New York Heart Association (NYHA) functional status classification. Further information will include biochemical markers such as serum albumin albumin, white cell count (WCC), renal functions.

ii. Intraoperative information: duration of surgery, estimated blood loss, pancreatic duct size, pancreatic texture, amount and type of fluid administered, fluid balances and type of anastomoses.

iii. postoperative data: fluid balances and renal function of postoperative day 1 to 3, duration of ICU stay, readmission to ICU, length of hospital stay, duration to standard feeds, grading of pancreatic fistula (where relevant), surgical site infection, duration to removal of urinary catheter, cardiac complications, renal and pulmonary complications, deep vein thrombosis, re-operation, and mortality.

Details
Condition Pancreatic Cancer, Pancreatic disorder, Pancreatic Fistula, Gastroparesis, Anastomotic Leak, Neoplasm of unspecified nature of digestive system, Pancreaticoduodenectomy, Pancreatic Disorders, Diabetic Gastroparesis, Islet Ce417ll Cancer, Digestive System Neoplasms, anastomotic leakage, anastomotic leaks, delayed gastric emptying, gastric atony, cancer of the pancreas, pancreatic cancers, cancer, pancreatic, whipple procedure
Treatment Human albumin
Clinical Study IdentifierNCT04418739
SponsorUniversiti Kebangsaan Malaysia Medical Centre
Last Modified on20 October 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

All patients undergoing pancreaticoduodenectomy that can consent to the study

Exclusion Criteria

Patients with known allergy to human albumin
Patients of American Society of Anaesthesiologist (ASA) physical status class 3 and above
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