Updated clinical practice guidelines for the management of biliary tract cancers: revision concepts and major revised points

Journal of Hepato-biliary-pancreatic Sciences
Hideyuki YoshitomiMasaru Miyazaki

Abstract

In 2008, the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS) launched the clinical practice guideline for the management of biliary tract cancers. JSHBPS decided to revise these guidelines for distribution of updated points concerning the treatment of biliary tract cancers. To make clearer recommendations, we introduced the concepts of Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, in which the strength of recommendations are decided considering not only quality of evidence, but also balance of benefits and harms/burdens, patients' preferences, and cost benefits. We emphasize the importance of the dynamic contrast enhanced multiple row detector CT (MDCT) in the diagnosis of biliary tract and gallbladder carcinomas. For biliary drainage, we suggest to perform endoscopic approaches instead of percutaneous approach to avoid complications. Regarding the surgical treatments, we included new clinical questions about the importance of combined vascular resection, intraoperative histological examination of the bile duct resection margin, and the combined extrahepatic bile duct resection for the gallbladder carcinoma. We also discussed details about premalignant lesions and non-neopla...Continue Reading

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Citations

Mar 20, 2015·Journal of Hepato-biliary-pancreatic Sciences·Masaru MiyazakiTadahiro Takada
Oct 4, 2015·Gastrointestinal Endoscopy Clinics of North America·Majid A AlmadiAlan N Barkun
Nov 9, 2017·Journal of Hepato-biliary-pancreatic Sciences·Hongeun LeeJin-Young Jang
Dec 2, 2020·Journal of Hepato-biliary-pancreatic Sciences·Masato NaginoItaru Endo
Dec 11, 2020·Cancers·Patricia García On Behalf Of The European-Latin American Escalon Consortium

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