Procalcitonin-guided care for adhesion-related small bowel obstruction
Official title: Impact of a Procalcitonin-based Algorithm on Quality of Management in Patients With Uncomplicated Adhesion-related Small Bowel Obstruction Assessed by Textbook Outcome: a Multicenter Cluster-randomized Open-label Controlled Trial. (ALPROC)
Run by Centre Hospitalier Universitaire, Amiens · NCT03905239 · Data updated 2026-11-12
This study tests whether using blood procalcitonin levels to guide the choice between surgery and conservative care helps adults with adhesion-related small bowel obstruction.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 488 (estimated) |
| Sponsor | Centre Hospitalier Universitaire, Amiens Academic / other |
| Locations | 1 site (Amiens) |
| Status | Recruiting |
| Started | April 1, 2019 |
| Main results expected | October 2025 |
| Study ends | August 1, 2026 |
| Registry record updated | June 8, 2025 |
| Trial ID | NCT03905239 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults with uncomplicated adhesion-related small bowel obstruction who can give informed consent, are covered by national health insurance, and have no signs requiring immediate surgery are ideal candidates.
✕Probably not a fit
Patients with signs of peritonitis or strangulation, recent abdominal surgery (within 4 weeks), large-bowel obstruction, active infection, known bowel cancer or inflammatory bowel disease, pregnancy, minors, or those unable to consent are unlikely to benefit from this protocol.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
Adults with uncomplicated adhesion-related small bowel obstruction will be managed using a predefined algorithm that incorporates blood procalcitonin (PCT) measurements alongside standard clinical and CT assessments. Eligible patients are enrolled at participating French university hospitals and managed according to the algorithm to decide early surgery versus conservative treatment. Key outcomes include rates of surgery, need for bowel resection, length of hospital stay, and in-hospital complications, with follow-up through the immediate hospitalization period. The strategy aims to reduce delayed emergency operations for strangulation and avoid unnecessary laparotomies by using PCT as a potential marker of infection and bowel ischemia.
Why it matters
Potential benefit: If successful, the PCT-based algorithm could reduce unnecessary surgeries, lower rates of delayed bowel resection, and shorten hospital stays.
How similar studies have gone: Using procalcitonin to guide decisions in suspected bowel ischemia is relatively novel: small studies suggest it may help identify infection or ischemia, but large randomized evidence is limited.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Uncomplicated acute adhesion-related small bowel obstruction (ASBO) * Adults * Patients able to express consent * Signed written informed consent form * Covered by national health insurance Exclusion Criteria: * Disease-related criteria: * Large bowel obstruction * No previous abdominal surgery * Signs of peritonitis or strangulation requiring emergency surgery) * Obstruction within 4 weeks following previous surgery * Ongoing or history of bowel cancer * Ongoing or in history of inflammatory bowel disease * History of abdominal radiotherapy * Active infection * Contraindication to contrast-enhanced CT scan * Minors * Patient deprived of liberty by administrative or judicial decision or placed under judicial protection (guardianship or supervision) * Pregnancy or breastfeeding
Where it's running
-
Amiens Universitary Hospital
Amiens, France Recruiting
Study contacts
- Principal investigator: Jean-Marc Regimbeau, Pr — CHU Amiens
- Study coordinator: Jean-Marc Regimbeau, Pr
- Email: regimbeau.jean-marc@chu-amiens.fr
- Phone: (33) 322 088 897
Similar studies
Other studies for the same condition or treatment. Recruiting studies are listed first.
-
Deferring a nasogastric tube in non-operatively managed small bowel obstruction
This trial tests whether not placing a nasogastric tube in patients with small bowel obstruction who are not having immediate surgery can reduce respiratory complications.
-
GT Metabolic Magnet System to create side-to-side connections in the stomach or small intestine
This study will test whether the GT Metabolic Magnet System can safely create side-to-side connections in the stomach or small intestine for adults with gastric outlet obstruction, partial small bowel obstruction, or superior mesenteric artery syndrome.
-
Using Point of Care Ultrasound to Diagnose Small Bowel Obstruction in Emergency Departments
This study tests whether using ultrasound in the emergency department can help doctors quickly and safely diagnose small bowel obstruction instead of relying on CT scans.
-
Comparing early surgery to 3 days of non-surgical management for acute small bowel obstruction
This study is testing whether early surgery or a 3-day wait-and-see approach is better for helping people with a blocked small intestine recover and avoid complications.
-
Evaluating the timing of contrast media administration for small bowel obstruction
This study is testing if giving a special type of liquid sooner or later after a tube is placed in the stomach can help people with a small bowel blockage feel better faster.
How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.