Periampullary Carcinoma

The goal of this clinical trial is to evaluate whether a wearable-enabled prehabilitation and rehabilitation pathway can improve recovery and post-operative outcomes in adults undergoing surgery for pancreatic cancer or related pancreatic/periampullary conditions. The main questions it aims to answer are: Does a wearable-enabled prehabilitation and rehabilitation programme reduce post-operative complications within 30 and 90 days after surgery? Is the use of wearable devices and remote monitoring feasible, acceptable, and useful for patients and healthcare professionals during the perioperative pathway? Researchers will compare patients receiving the wearable-enabled pathway with a matched historical control group who received standard care to determine whether the intervention is associated with improved surgical and recovery outcomes. Participants will: Provide informed consent and complete baseline assessments and questionnaires. Take part in the Greater Manchester Prehab4Cancer programme before surgery, including personalised exercise, nutritional support, and wellbeing support. Wear a Corsano CardioWatch device to continuously monitor physiological and activity data. Use home monitoring equipment, including weight scales and blood pressure monitoring devices. Complete questionnaires and participant logs during prehabilitation and recovery. Receive regular support from the research team during participation. Undergo pancreatic surgery and receive standard NHS perioperative care. Continue wearable monitoring and rehabilitation after hospital discharge. Be followed for up to 12 months after surgery using routine clinical data to assess recovery, complications, hospital utilisation, and survival. Optionally participate in a focus group to discuss their experiences of wearable-enabled care.

Pancreaticoduodenectomy (PD) is a complex procedure performed in patients with malignant or benign tumors of the pancreatic head and periampullary region, associated with high morbidity and mortality. Postoperative pancreatic fistula (POPF) is the most common and clinically significant complication following PD. In this study, the investigators aim to determine the predictive risk factors for clinically related postoperative pancreatic fistula (CR-POPF) in the preoperative, intraoperative and postoperative period in patients that underwent PD. The total number of 100 participants expected to be included in this research who underwent PD between 2025 and 2026.

Pancreatic fistula is one of the most serious complication after pancreatoduodenectomy. To reduce pancreatic fistula, many authors recommend different techniques in pancreatojejunostomy. The purpose of this study is to determine which is the best method in preventing pancreatic fistula by enforce pancreaticojejunostomy with tissue glue .

laparoscopic pancreaticoduodenectomy(LPD) and Robot Pancreaticoduodenectomy (RPD), as two minimally invasive methods of pancreaticoduodenectomy(PD), have obvious advantages over traditional open pancreaticoduodenectomy(OPD) in terms of reducing surgical trauma and hospitalization time, but there are few studies on their perioperative safety and prognostic effects.However, there are few studies on the perioperative safety and prognostic effects of both procedures. In this trial, the perioperative data and prognosis of both procedures were collected and analyzed through a prospective, multicenter approach to investigate the advantages and disadvantages of both procedures.

Further studies are needed to investigate the prognosis and perioperative safety of patients undergoing robotic-assisted pancreaticoduodenectomy. In this study, clinical data and prognostic data of patients undergoing this procedure were prospectively collected and analyzed to explore its safety and efficacy.