[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"cholangio-carcinoma\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:cholangio-carcinoma":29},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,2,0,[8,48],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":13,"acronym":14,"eligibilityCriteria":15,"healthyVolunteers":11,"sex":16,"minAge":17,"maxAge":4,"enrollmentInfo":18,"targetDuration":21,"studyType":22,"phases":4,"briefSummary":23,"conditions":24,"keywords":32,"overallStatus":35,"whyStopped":4,"lastUpdateSubmitDate":36,"lastUpdatePostDateStruct":37,"startDateStruct":40,"completionDateStruct":42,"leadSponsor":44,"locationsCount":47},"100608807","in-depth-characterisation-of-biliary-strictures-and-hepato-pancreato-biliary-focal-lesions-for-development-of-new-technologies-to-tackle-hepato-pancreato-biliary-cancers-100608807",false,"NCT07206355","In-Depth Characterisation of Biliary Strictures and Hepato-Pancreato-Biliary Focal Lesions for Development of New Technologies to Tackle Hepato-Pancreato-Biliary Cancers","Map HPB","Inclusion Criteria:\n\n* Aged 16 years and over\n* Ability to provide informed consent to participate in the study\n* Patients attending Nottingham University Hospitals NHS Trust (NUH) as part of standard clinical care for either:\n\n  * the diagnosis and treatment of suspected biliary stricture or any focal lesion in the Hepato-Pancreato-Biliary (HPB) tract (clinically \u002F radiologically) including liver or pancreatic lesion or pancreatic cyst\n  * surgical resection treatment of liver, pancreas, or gall bladder including Whipple Procedure (pancreaticoduodenectomy surgery), gall bladder resection (cholecystectomy), hepatic resection\n\nExclusion Criteria: No exclusion criteria","ALL","16 Years",{"count":19,"type":20},160,"ESTIMATED","5 Years","OBSERVATIONAL","Hepato-Pancreato-Biliary (HPB) cancers originating in the liver, bile ducts, pancreas, and gall bladder represent a rising global health challenge, with incidence doubling in the UK over the past decade. Cholangiocarcinoma (CCA) and pancreatic cancer are particularly aggressive, often detected late due to non-specific symptoms and difficulties in sampling or imaging. In the UK, CCA affects around 3,000 people annually, with only 13% surviving 3 years, while pancreatic cancer has a 5-year survival of 8.3%. Diagnosis is complicated by the anatomical narrowness of the bile duct and the similarity between malignant and benign strictures. Standard imaging often cannot distinguish between inflammation and cancer, while tissue sampling is challenging, paucicellular, and limited in sensitivity, necessitating repeated biopsies. Yet, accurate characterisation is critical as NICE now recommends targeted therapies (FGFR2, NTRK, MSI-H\u002FdMMR, IDH1 mutations) that require molecular profiling.\n\nBoth CCA and PDAC display high heterogeneity, further complicating treatment. Emerging approaches such as Raman spectroscopy can map malignant tissues by detecting vibrational energy shifts, but require further validation due to weak signals. For focal or cystic HPB lesions not well visualised by conventional imaging, novel modalities like ultra-thin endoscopes with scattering\u002Fabsorption imaging are being developed for improved early diagnosis.\n\nManagement of biliary obstruction frequently involves stenting to restore bile flow, essential for palliation and pre-treatment optimization. However, stent failure from tumour ingrowth, displacement, or erosion remains common, and evidence for best stent use is limited. Novel approaches, including drug-eluting coatings and nanoparticle-mediated wireless treatment delivery, are being investigated.\n\nTo overcome diagnostic and therapeutic barriers, flexible snake-like robotic systems with navigation, sampling, spectroscopy, and treatment capabilities are being developed. These devices, alongside ultra-thin endoscopes and integrated Raman spectroscopy, aim to characterise strictures, generate 3D imaging in ex-vivo HPB tissue, and permit targeted ablation. Parallel work will explore molecular and fluid-based biomarkers (blood, bile, cyst fluid) to support minimally invasive diagnosis and monitoring.\n\nThrough integration of engineering, molecular diagnostics, and device innovation, this transdisciplinary research programme (UKRI and MRC funded) seeks to transform early detection, accurate diagnosis, and novel treatment of HPB cancers, thereby improving outcomes in CCA, pancreatic malignancy, and other clinically similar biliary disorders.\n\nAim:\n\nTo provide a detailed understanding of the characteristics (including clinical and molecular) of liver and pancreatic biliary focal lesions (inflammatory and cancerous) and create a bioresource of liver, pancreas, gallbladder and biliary tract associated tissue and fluids (biopsies, brushings, resected tissues, bile and cyst fluid and blood samples) in order to develop innovative tools for accurate diagnosis and treatment.\n\nStudy Configuration: Prospective Longitudinal Cohort study Setting: Secondary care centre, Nottingham University Hospitals NHS Trust. (NUH).\n\nCo-ordinated by the NIHR Nottingham Biomedical Research Centre Description of interventions: This is an observational study involving collecting tissue or body fluids (such as bile or pancreatic cyst fluid) during clinical care in addition to collection of blood samples (for DNA, serum and plasma) and data collection.\n\nSurplus tissue residual to the requirements for standard care will be stored and used. Additional tissue samples and body fluid samples collected for research at time of clinical investigations will not be increasing the risk of the clinical procedure.\n\nBlood samples will be collected from patients at the time of enrolment in the study. These may be collected before and\u002F or after diagnosis is secured.\n\nDuration of study: Overall duration: 60 months Outcome measures: - To report the proportion of patients where adequate tissue could be retrieved from HPB biopsy to come to definitive diagnosis using standard of care.\n\n* To report the proportion of patients where adequate tissue could be retrieved from biopsy to perform molecular characterisation of HPB samples, beyond standard cyto\u002Fhistology, using advanced optical-spatial technologies currently under development.\n* To report the proportion of patients where definitive diagnosis of mucinous cystic neoplasm could be made in patients with pancreatic cyst using standard care\n* To report the proportion of patients where molecular characterisation beyond standard cyto\u002Fhistology could be made in patients with pancreatic cyst using exploratory new technologies under development through ex-vivo experiments\n* To report the correlation between Raman Spectroscopy and standard cyto\u002Fhistology for identification of cancer in HPB samples",[25,26,27,28,29,30,31],"Biliary Tract Cancer (BTC)","Biliary Tract Cancer (CCA)","Cholangiocarcinoma","Cholangiocarcinoma Cancer","Cholangio Carcinoma","Pancreatic Cancer","Pancreatic Cyst",[33,30,31,34,25,27],"biliary tract cancer","Pancreatic lesions","RECRUITING","2026-04-28",{"date":38,"type":39},"2026-04-29","ACTUAL",{"date":41,"type":39},"2026-01-25",{"date":43,"type":20},"2030-09-30",{"name":45,"class":46},"University of Nottingham","OTHER",1,{"id":49,"slug":50,"hasResults":11,"nctId":51,"briefTitle":52,"officialTitle":53,"acronym":54,"eligibilityCriteria":55,"healthyVolunteers":11,"sex":16,"minAge":56,"maxAge":4,"enrollmentInfo":57,"targetDuration":4,"studyType":59,"phases":60,"briefSummary":62,"conditions":63,"keywords":73,"overallStatus":35,"whyStopped":4,"lastUpdateSubmitDate":83,"lastUpdatePostDateStruct":84,"startDateStruct":86,"completionDateStruct":88,"leadSponsor":90,"locationsCount":47},"100613159","phase-4-preventing-postoperative-complications-in-patients-undergoing-high-risk-pancreatoduodenectomy-with-a-bundle-approach-including-hydrocortisone-octreotide-and-the-teres-ligament-patch-panenca-100613159","NCT07262957","Preventing Postoperative Complications in Patients Undergoing High-risk Pancreatoduodenectomy With a Bundle Approach Including Hydrocortisone, Octreotide, and the Teres Ligament Patch (PANENCA)","Preventing Postoperative Complications in Patients Undergoing High-risk Pancreatoduodenectomy With a Bundle Approach Including Hydrocortisone, Octreotide, and the Teres Ligament Patch (PANENCA): an International Randomized Controlled Multicenter Trial","PANENCA","Inclusion Criteria:\n\n* Elective pancreatoduodenectomy for any indication (both minimally invasive and open)\n* Pancreatic duct diameter ≤ 3mm on preoperative CT or MRI\\*\n* 18 years of age or older\n* Signature of informed consent\n* In the opinion of the investigator, the patient is eligible for the administration of hydrocortisone and octreotide, based on contraindications, warnings, and precautions as listed in the respective SmPCs\n\nExclusion Criteria:\n\n* Age \\\u003C 18 years\n* Pregnancy or current breastfeeding\n* Known allergy or hypersensitivity to hydrocortisone or octreotide\n* Systemic fungal infection\n* Concomitant use of strong CYP3A4 inhibitors or moderate-to-strong inducers that cannot be discontinued (see CYTOCHROME P450 DRUG INTERACTION TABLE (iu.edu))\n\n  * Inhibitors must be discontinued ≥7 days before randomization\n  * Inducers must be discontinued ≥28 days before randomization","18 Years",{"count":58,"type":20},400,"INTERVENTIONAL",[61],"PHASE4","The PANENCA trial aims to reduce postoperative complications in patients undergoing pancreatoduodenectomy (also known as a Whipple procedure), a complex surgical operation performed to remove tumors located in or near the head of the pancreas. One of the most frequent and serious complications after this surgery is postoperative pancreatic fistula (POPF), a leakage of pancreatic fluid from the surgical connection. POPF can lead to intra-abdominal infection, bleeding, and inflammation, often resulting in delayed recovery and postponement of subsequent oncological treatment. In severe cases, these complications may be life-threatening.\n\nPatients with a small main pancreatic duct (3 millimeters or less) are known to have a substantially higher risk of developing POPF. Previous studies have shown that several existing interventions may reduce the risk or severity of these complications. These include hydrocortisone, a medication that suppresses postoperative inflammation; octreotide, a medication that reduces the production of pancreatic secretions; and a surgical technique known as the ligamentum teres hepatis patch, which uses the patient's own tissue to protect nearby blood vessels in the event of a pancreatic leak.\n\nBecause the development of pancreatic fistulas is multifactorial, the investigators hypothesize that a combined approach targeting different underlying mechanisms may provide a complementary and more effective protective effect than any single intervention alone. The PANENCA trial therefore evaluates whether the combined use of hydrocortisone, octreotide, and the ligamentum teres patch can reduce the rate of major postoperative complications after pancreatoduodenectomy.\n\nPatients participating in the study are randomly assigned to receive either the combination treatment in addition to standard perioperative care or standard perioperative care alone. The study medications are administered only during the first postoperative days, and the surgical patch is applied during the operation itself. No additional tests, monitoring procedures, or hospital visits are required beyond routine clinical care.\n\nThis international, multicenter randomized trial includes patients at high risk for POPF who are undergoing pancreatoduodenectomy. The primary objective is to determine whether the combination treatment reduces the incidence of major postoperative complications. If proven effective, this bundle approach may be implemented more consistently across participating countries and incorporated into international clinical guidelines for pancreatic surgery.",[64,65,66,29,67,68,69,70,71,72],"Pancreas Head Cancer","Pancreas Adenocarcinoma","IPMN, Pancreatic","Ampulla of Vater Adenocarcinoma","PDAC - Pancreatic Ductal Adenocarcinoma","Duodenal Carcinoma","Mucinous Cystic Neoplasm","Neuro Endocrine Tumours","Pancreatitis",[74,75,76,77,78,79,80,81,82],"Whipple","Pancreatoduodenectomy","POPF","Major complications","Fistula","ISGPS","Hydrocortisone","Octreotide","Ligament teres patch","2025-12-16",{"date":85,"type":39},"2025-12-22",{"date":87,"type":39},"2025-09-01",{"date":89,"type":20},"2027-12-01",{"name":91,"class":46},"Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)"]