Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma

Hilar cholangiocarcinoma (HCCA) is one of the most common types of hepatobiliary cancers reported in the world including Asia-Pacific region. Early HCCA may be completely asymptomatic. When significant hilar obstruction develops, the patient presents with jaundice, pale stools, dark urine, pruritus,...

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Main Authors: Rungsun Rerknimitr, Phonthep Angsuwatcharakon, Thawee Ratanachu-ek, Christopher J.L. Khor, Ryan Ponnudurai, Jong Ho Moon, Dong Wan Seo, Linda Pantongrag-Brown, Apichat Sangchan, Pises Pisespongsa, Thawatchai Akaraviputh, Nageshwar D. Reddy, Amit Maydeo, Takao Itoi, Nonthalee Pausawasdi, Sundeep Punamiya, Siriboon Attasaranya, Benedict Devereaux, Mohan Ramchandani, Khean Lee Goh
Other Authors: Chulalongkorn University
Format: Review
Published: 2018
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/32703
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spelling th-mahidol.327032018-10-19T12:40:21Z Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma Rungsun Rerknimitr Phonthep Angsuwatcharakon Thawee Ratanachu-ek Christopher J.L. Khor Ryan Ponnudurai Jong Ho Moon Dong Wan Seo Linda Pantongrag-Brown Apichat Sangchan Pises Pisespongsa Thawatchai Akaraviputh Nageshwar D. Reddy Amit Maydeo Takao Itoi Nonthalee Pausawasdi Sundeep Punamiya Siriboon Attasaranya Benedict Devereaux Mohan Ramchandani Khean Lee Goh Chulalongkorn University Rajavithi Hospital Faculty of Medicine, Ramathibodi Hospital, Mahidol University Mahidol University Khon Kaen University Faculty of Medicine, Chiang Mai University Prince of Songkla University National University Health System Tan Tock Seng Hospital Prince Court Medical Centre University of Malaya Soonchunhyang University, College of Medicine University of Ulsan, College of Medicine Asian Institute of Gastroenterology India Institute of Advanced Endoscopy Tokyo Medical University Royal Brisbane and Women's Hospital Medicine Hilar cholangiocarcinoma (HCCA) is one of the most common types of hepatobiliary cancers reported in the world including Asia-Pacific region. Early HCCA may be completely asymptomatic. When significant hilar obstruction develops, the patient presents with jaundice, pale stools, dark urine, pruritus, abdominal pain, and sometimes fever. Because no single test can establish the definite diagnosis then, a combination of many investigations such as tumor markers, tissue acquisition, computed tomography scan, magnetic resonance imaging/magnetic resonance cholangiopancreatography, endoscopic ultrasonography/intraductal ultrasonography, and advanced cholangioscopy is required. Surgery is the only curative treatment. Unfortunately, the majority of HCCA has a poor prognosis due to their advanced stage on presentation. Although there is no survival advantage, inoperable HCCA managed by palliative drainage may benefit from symptomatic improvement. Currently, there are three techniques of biliary drainage which include endoscopic, percutaneous, and surgical approaches. For nonsurgical approaches, stent is the most preferred device and there are two types of stents i.e. plastic and metal. Type of stent and number of stent for HCCA biliary drainage are subjected to debate because the decision is made under many grounds i.e. volume of liver drainage, life expectancy, expertise of the facility, etc. Recently, radio-frequency ablation and photodynamic therapy are promising techniques that may extend drainage patency. Through a review in the literature and regional data, the Asia-Pacific Working Group for hepatobiliary cancers has developed statements to assist clinicians in diagnosing and managing of HCCA. After voting anonymously using modified Delphi method, all final statements were determined for the level of evidence quality and strength of recommendation. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd. 2018-10-19T05:40:21Z 2018-10-19T05:40:21Z 2013-01-01 Review Journal of Gastroenterology and Hepatology (Australia). Vol.28, No.4 (2013), 593-607 10.1111/jgh.12128 14401746 08159319 2-s2.0-84875594063 https://repository.li.mahidol.ac.th/handle/123456789/32703 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84875594063&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Rungsun Rerknimitr
Phonthep Angsuwatcharakon
Thawee Ratanachu-ek
Christopher J.L. Khor
Ryan Ponnudurai
Jong Ho Moon
Dong Wan Seo
Linda Pantongrag-Brown
Apichat Sangchan
Pises Pisespongsa
Thawatchai Akaraviputh
Nageshwar D. Reddy
Amit Maydeo
Takao Itoi
Nonthalee Pausawasdi
Sundeep Punamiya
Siriboon Attasaranya
Benedict Devereaux
Mohan Ramchandani
Khean Lee Goh
Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma
description Hilar cholangiocarcinoma (HCCA) is one of the most common types of hepatobiliary cancers reported in the world including Asia-Pacific region. Early HCCA may be completely asymptomatic. When significant hilar obstruction develops, the patient presents with jaundice, pale stools, dark urine, pruritus, abdominal pain, and sometimes fever. Because no single test can establish the definite diagnosis then, a combination of many investigations such as tumor markers, tissue acquisition, computed tomography scan, magnetic resonance imaging/magnetic resonance cholangiopancreatography, endoscopic ultrasonography/intraductal ultrasonography, and advanced cholangioscopy is required. Surgery is the only curative treatment. Unfortunately, the majority of HCCA has a poor prognosis due to their advanced stage on presentation. Although there is no survival advantage, inoperable HCCA managed by palliative drainage may benefit from symptomatic improvement. Currently, there are three techniques of biliary drainage which include endoscopic, percutaneous, and surgical approaches. For nonsurgical approaches, stent is the most preferred device and there are two types of stents i.e. plastic and metal. Type of stent and number of stent for HCCA biliary drainage are subjected to debate because the decision is made under many grounds i.e. volume of liver drainage, life expectancy, expertise of the facility, etc. Recently, radio-frequency ablation and photodynamic therapy are promising techniques that may extend drainage patency. Through a review in the literature and regional data, the Asia-Pacific Working Group for hepatobiliary cancers has developed statements to assist clinicians in diagnosing and managing of HCCA. After voting anonymously using modified Delphi method, all final statements were determined for the level of evidence quality and strength of recommendation. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
author2 Chulalongkorn University
author_facet Chulalongkorn University
Rungsun Rerknimitr
Phonthep Angsuwatcharakon
Thawee Ratanachu-ek
Christopher J.L. Khor
Ryan Ponnudurai
Jong Ho Moon
Dong Wan Seo
Linda Pantongrag-Brown
Apichat Sangchan
Pises Pisespongsa
Thawatchai Akaraviputh
Nageshwar D. Reddy
Amit Maydeo
Takao Itoi
Nonthalee Pausawasdi
Sundeep Punamiya
Siriboon Attasaranya
Benedict Devereaux
Mohan Ramchandani
Khean Lee Goh
format Review
author Rungsun Rerknimitr
Phonthep Angsuwatcharakon
Thawee Ratanachu-ek
Christopher J.L. Khor
Ryan Ponnudurai
Jong Ho Moon
Dong Wan Seo
Linda Pantongrag-Brown
Apichat Sangchan
Pises Pisespongsa
Thawatchai Akaraviputh
Nageshwar D. Reddy
Amit Maydeo
Takao Itoi
Nonthalee Pausawasdi
Sundeep Punamiya
Siriboon Attasaranya
Benedict Devereaux
Mohan Ramchandani
Khean Lee Goh
author_sort Rungsun Rerknimitr
title Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma
title_short Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma
title_full Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma
title_fullStr Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma
title_full_unstemmed Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma
title_sort asia-pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma
publishDate 2018
url https://repository.li.mahidol.ac.th/handle/123456789/32703
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