Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
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, Jeonju, Korea.
Gut Liver. 2024 Jan 15;18(1):174-183. doi: 10.5009/gnl220413. Epub 2023 Apr 20.
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.
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.
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.
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.
背景/目的：根据解剖学特征，胆管癌（CCA）可分为肝内型、肝门型和远端型。尽管每种类型 CCA 的诊断和治疗方法被认为不同，但目前关于实际操作的数据研究有限。因此，本研究旨在收集韩国当前治疗肝门部 CCA 的实践情况。
我们使用在线平台进行了一项调查。问卷包括 18 个问题，旨在评估韩国当前诊断和治疗肝门部 CCA 的实践情况。该调查的目标人群是韩国胆胰协会的胆道内镜医生。
共有 119 名胆道内镜医生完成了这项调查。在应答者中，89.9%的人认为使用国际疾病分类第 11 版（ICD-11）系统对 CCA 进行分类是必要的。大约一半的应答者会建议患者在 80 岁之前进行手术或化疗。对于 CCA 的病理诊断，内镜逆行胰胆管造影加活检是最受欢迎的方式。44.5%的应答者会常规进行术前胆道引流。对于可手术的 CCA，64.7%的应答者倾向于使用塑料支架进行内镜胆道引流。对于姑息性胆道引流，69.7%的应答者使用塑料支架。对于姑息性内镜胆道引流使用金属支架，63%的应答者倾向于采用支架内支架方法。
需要使用 ICD-11 制定新的编码系统来分类 CCA。需要根据韩国的临床情况制定诊断和治疗 CCA 的指南。
