Clinical Research Directory

Development and Prospective Validation of an AI-Based Diagnostic Model for Hepato-Pancreato-Biliary Diseases

The rapid advancement of artificial intelligence (AI) has expanded its applications in healthcare, particularly in diagnostic assistance, intelligent triage, and patient interaction. Hepatobiliary and pancreatic diseases (such as liver cancer, pancreatic cancer, cirrhosis) are characterized by insidious onset, rapid progression, low early-diagnosis rates, and poor prognosis. However, grassroots medical institutions in China face challenges including physician shortages, variable patient health literacy, and incomplete initial information collection, leading to high misdiagnosis/missed diagnosis risks. Recent breakthroughs in large language models (LLMs) and multi-agent systems (MAS) offer new solutions. LLMs enable advanced natural language processing, while MAS coordinates specialized agents for complex decision-making. Integrating MAS with medical LLMs could create intelligent pre-consultation systems that systematically collect patient symptoms, risk factors, family history, and lifestyle data to enhance diagnostic efficiency. This study aims to develop a MAS-based pre-consultation system for hepatobiliary-pancreatic diseases featuring four specialized agents ("guidance agent," "medical history agent," "risk assessment agent," and "summary generation agent"). The system will simulate clinical reasoning to generate structured diagnostic reports for physicians. Research Objectives: Develop a specialized multi-agent framework combining LLMs to simulate clinical diagnostic logic and standardize symptom collection Enhance pre-consultation data integrity through intelligent dialogue focusing on key disease indicators Generate structured diagnostic summaries highlighting critical symptoms and risk factors Establish foundation for clinical validation and application through expert evaluation and user feedback This pre-diagnostic tool will assist physicians rather than replace clinical judgment, promoting safe, effective AI applications in early disease screening and tiered healthcare systems.

Safety of Stopping Pancreatic Enzyme Replacement Therapy in Children With Improved Pancreatic Function After Highly Effective Modulator Therapy

The goal of this clinical trial is to evaluate the safety of stopping pancreatic enzyme replacement therapy (PERT) in children with cystic fibrosis (CF) receiving CFTR modulator therapy (CFTRm) who have regained pancreatic sufficiency. The main questions it aims to answer are: 1. Does discontinuation of PERT affect gastrointestinal symptoms, nutritional status, pancreatic function, or body composition over 6 months? 2. Does stopping PERT increase gastrointestinal symptoms or affect nutritional status, pancreatic function, or body composition compared with continuing PERT? Researchers will evaluate changes in growth, gastrointestinal symptoms, vitamin levels, pancreatic function, and body composition following PERT discontinuation. Participants will: * Complete study visits and assessments over 6 months * Continue or discontinue PERT based on study assignment * Undergo anthropometric measurements * Complete questionnaires about gastrointestinal symptoms * Provide blood samples to assess vitamin levels and coagulation markers * Provide stool samples to measure fecal elastase-1 (FE-1) and evaluate pancreatic function

A COMBINATION OF RECTAL INDOMETHACIN AND COLD WATER EXPOSURE OF THE AMPULLA AFTER ERCP IS SUPERIOR TO RECTAL INDOMETHACIN ALONE IN REDUCING THE INCIDENCE OF POST-ERCP PANCREATITIS -RCT

Endoscopic retrograde cholangiopancreatography (ERCP) has emerged as the primary modality in the management of biliary and pancreatic disease. The complications occurring from ERCP can range from mild to fatal. Procedure related complications are Pancreatitis , Bleeding , Infections- Cholangitis, Cholecystitis , Perforations of which Post-ERCP pancreatitis (PEP) is the most common serious adverse event. Reported incidence of PEP is 8.6-10.7% according to studies(overall RCTs).In India it is 6.6% (2020 study). Prevention as well as early detection and management of PEP results in a satisfactory outcome. Multiple RCTs and meta-analyses show rectal indomethacin/diclofenac significantly reduce PEP in average- and high-risk patients; now recommended by ASGE/ESGE for nearly all ERCPs. Other measures for prevention of PEP are prophylactic pancreatic duct stents in high-risk anatomy/instrumentation; wire-guided cannulation; minimizing PD contrast; periprocedural aggressive lactated Ringer's hydration. Cryoprevention effect was shown to reduce postprocedure papillary edema and thus lower the risk of PEP 1. Rectal NSAIDs reduce but do not eliminate PEP. 2. Cold-water ampullary cooling is biologically plausible but under-studied. 3. First study to demonstrate if combination of rectal indomethacin and cold-water irrigation may have a synergistic effect. 4. First study in Indian population.

Time to Post-operative Recovery of Serum Albumin as a Predictor of Outcome in Major Hepato Pancreato Biliary Surgeries

Hepatobiliary and Pancreatic surgery is associated with substantial risk of postoperative complications. Albumin is a negative acute phase protein. Its rapid decline may be due to degree of inflammation due to surgical procedures. The decline may due to multifactorial causes. Currently, contemporary data regarding the time to recovery of albumin, as a marker for early recovery of patient from surgical stress is sparse. Delta albumin is influenced by perioperative fluid administration and albumin supplementation. Delta albumin may not reflect the true surgical stress. Early post op albumin is a reflection of intraoperative events and not postoperative recovery or events and is unpredictable. Shorter recovery time of albumin is associated with less post op complications and hospital stay. Earlier recovery of albumin predicts lower morbidity and shorter hospital stay.

Artificial Intelligence in Endoscopic Ultrasound

The objective of the study is to determine if this artificial intelligence system is capable of detecting abnormalities in the pancreas that are identified by an endoscopist at endoscopic ultrasound procedures.

Intermittent Fasting for Pancreatitis

The purpose of this research is to compare intermittent fasting with a standard diet approach for improving the quality of life related to your pancreas disease. Our hope is to improve your symptoms and prevent you from needing to go into the hospital for pancreas-related issues.

Bio-Repository of High Risk Cohorts for the Early Detection of Pancreas Cancer

Bio-repository to collect bio-specimens from patients with 1) pancreatic cysts and 2) patients at high risk, defined by family history and/or genetic mutations, for pancreatic cancer.

Radiology Registry on Pancreatic Malignancies

The purpose of this study is to collect all radiological data which evaluated with clinical data may help assess malignancy and prognosis of pancreatic disease.This registry aims to collect retrospective data from 2014 and prospective data until 2027 with a maximum follow-up of 3 years per patient.

Survival, Quality of Life and Resectability in Locally Advanced Pancreatic Cancer

This study aims to assess overall survival, quality of life and resection rates in locally advanced pancreatic cancer

Prognostic Factors in Periampullary Tumors and Cysts

The project aims at analysing prognostic and predictive factors involved in diagnostics and surgical treatment of cysts and tumors in the pancreas and periampullary region using both clinical data and blood and tissue samples for biomarker development and validation.

Results of Surgical Treatment of the Hepatobiliopancreatic Surgical Unit

The main aims of this study are: 1. \- to evaluate post-surgical morbidity and mortality outcomes, following the criteria and the definitions from Claven-Dindo and ISGPS international classifications, of the patients operated by the HPB Surgical Unit. 2. \- to evaluate survival and disease-free survival rates of the patients operated by the HPB Surgical Unit due to tumoral cause.