Comparing two inner stents to keep bile drainage open in inoperable cancer
Tests two inner stents to keep bile drainage open in adults with cancer.
Plain-language title generated from the registry record
Registry title: Improving a Bile Duct Drainage Procedure in Patients With Inoperable Cancer Blocking the Bile Ducts: Comparing Two Types of Endoscopically Placed Internal Stents to Prevent Blockage of a Lumen Apposing Metal Stent
Key facts
- Where
- Hamilton, New ZealandSee the site
Where in New Zealand
- Waikato Hospital, Te Whatu Ora Health New Zealand WaikatoHamilton, New ZealandNo longer taking part
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Waikato Hospital
- Trial code
- NCT07115420
- Record updated
- 11 August 2025
- Original description
This study looks at the best way to treat bile duct blockage in people with advanced cancer that cannot be removed by surgery. A blocked bile duct can cause serious symptoms like yellowing of the skin (jaundice), infection, and pain.Read full original descriptionShow less
Optimising EUS-guided Choledochoduodenostomy With Lumen Apposing Metal Stent With Stent in Stent Placement: a Randomised Study Between Double Pigtail Stent and Fully Covered Self-Expanding Metal Stent. The Opti-LAMS Study
This study looks at the best way to treat bile duct blockage in people with advanced cancer that cannot be removed by surgery. A blocked bile duct can cause serious symptoms like yellowing of the skin (jaundice), infection, and pain.
A common procedure called ERCP sometimes doesn't work in these patients. A newer method called EUS-guided choledochoduodenostomy (EUS-CDS) uses internal ultrasound to place a special metal tube (called a LAMS) to allow bile to drain. However, over time this stent can still become blocked.
To reduce this risk, doctors can place a second stent inside the first. This study is comparing two types of these second stents:
* A plastic stent (double pigtail stent or DPS) * A metal stent (fully covered self-expanding metal stent or FCSEMS)
The study will include patients at Waikato Hospital. After the first stent is placed, they will be randomly assigned to receive either a DPS or FCSEMS. Patients will be followed for 6 months to see how well the stents work.
The aim is to find out which approach keeps the bile duct open longer and reduces the need for further procedures or hospitalisation, helping improve care and comfort for people with advanced cancer
Inclusion: Age ≥18 years; Radiologically or histologically proven malignant distal bile duct obstruction with unresectable or metastatic disease, including those who have already failed ERCP; Indication for biliary drainage with presence of obstructive jaundice biochemically and dilated biliary system on imaging; Informed consent provided; Common bile duct (CBD) size of at least 12mm on EUS imaging.
Exclusion: Previous biliary stenting or surgery precluding EUS-CDS; Inability to provide informed consent; Pregnancy; Significant coagulopathy that is not correctable; Futility of intervention e.g. pre-terminal patients.