Diagnosis and Treatment of Perihilar Cholangiocarcinoma: A National Survey from the Korean Pancreatobiliary Association
Eunae Cho,
Seong-Hun Kim,
Seong Ji Choi,
Min Kyu Jung,
Byeong Jun Song,
Jin Myung Park,
Jingu Kang,
Won Suk Park,
Joo Kyung Park,
Sang Myung Woo,
Hyo Jung Kim,
Study Group for Biliary Diseases,
Korean Pancreatobiliary Association
Affiliations
Eunae Cho
Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
Seong-Hun Kim
Division of Gastroenterology, Department of Internal Medicine, Jeonbuk National University Medical School and Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeo
Seong Ji Choi
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
Min Kyu Jung
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea
Byeong Jun Song
Division of Gastroenterology, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
Jin Myung Park
Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
Jingu Kang
Department of Gastroenterology, Kangdong Sacred Heart Hospital, Seoul, Korea
Won Suk Park
Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea
Joo Kyung Park
Division of gastroenterology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Sang Myung Woo
Research Institute, Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Korea
Hyo Jung Kim
Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
Background/Aims: Based on their anatomy, cholangiocarcinomas (CCAs) are classified into intrahepatic, hilar, and distal CCAs. Although the diagnosis and treatment of each type of CCA are thought to be different, real-world data studies on the current practice are limited. Therefore, this study was designed to capture the current practice of diagnosing and treating perihilar CCA in Korea. Methods: We conducted a survey using an online platform. The questionnaire consisted of 18 questions designed to evaluate the current practice of diagnosing and treating perihilar CCA in Korea. The targets of this survey were biliary endoscopists who are members of the Korean Pancreatobiliary Association. Results: In total, 119 biliary endoscopists completed the survey. Of the respondents, 89.9% thought that the use of the International Classification of Diseases, 11th Revision (ICD-11) system is necessary to classify CCA. Approximately half of the respondents would recommend surgery or chemotherapy until patients were 80 years of age. For the pathological diagnosis of CCA, endoscopic retrograde cholangiopancreatography with biopsy was the most preferred modality. Routine preoperative biliary drainage was performed by 44.5% of the respondents. For operable CCAs, 64.7% of the respondents preferred endoscopic biliary drainage using plastic stents. For palliative biliary drainage, 69.7% of the respondents used plastic stents. For palliative endoscopic biliary drainage using metal stents, 63% of the respondents preferred the stent-in-stent method. Conclusions: A new coding system using the ICD-11 is needed for classifying CCAs. Guidelines for diagnosing and treating CCA based on the clinical situation in Korea are needed.
