Continental Cancer Centre, Continental Hospitals, Hyderabad, India; Dept. of Surgical Oncology Lilavati Hospital & Research Centre and SL Raheja Hospital, Mumbai, India.
Department of Gastroenterological Surgery, Yokohama City University, Yokohama, Japan.
HPB (Oxford). 2024 Nov;26(11):1311-1326. doi: 10.1016/j.hpb.2024.07.411. Epub 2024 Jul 25.
The Delphi consensus study was carried out under the auspices of the International and Asia-Pacific Hepato-Pancreato-Biliary Associations (IHPBA-APHPBA) to develop practice guidelines for management of gallbladder cancer (GBC) globally.
GBC experts from 17 countries, spanning 6 continents, participated in a hybrid four-round Delphi consensus development process. The methodology involved email, online consultations, and in-person discussions. Sixty eight clinical questions (CQs) covering various domains related to GBC, were administered to the experts. A consensus recommendation was accepted only when endorsed by more than 75% of the participating experts.
Out of the sixty experts invited initially to participate in the consensus process 45 (75%) responded to the invitation. The consensus was achieved in 92.6% (63/68) of the CQs. Consensus covers epidemiological aspects of GBC, early, incidental and advanced GBC management, definitions for radical GBC resections, the extent of liver resection, lymph node dissection, and definitions of borderline resectable and locally advanced GBC.
This is the first international Delphi consensus on GBC. These recommendations provide uniform terminology and practical clinical guidelines on the current management of GBC. Unresolved contentious issues like borderline resectable/locally advanced GBC need to be addressed by future clinical studies.
本次德尔菲共识研究由国际肝胆胰协会联盟（IHPBA）和亚太地区肝胆胰协会联盟（APHPBA）主办，旨在制定全球胆囊癌（GBC）管理实践指南。
来自六大洲 17 个国家的 GBC 专家参与了四轮混合德尔菲共识开发过程。该方法涉及电子邮件、在线咨询和现场讨论。向专家们提出了 68 个涵盖与 GBC 相关的各种领域的临床问题（CQ）。只有超过 75%的参与专家认可，才能接受共识推荐。
最初邀请了 60 名专家参加共识过程，其中 45 名（75%）专家回应了邀请。在 68 个 CQ 中，有 92.6%（63/68）达成了共识。共识涵盖了 GBC 的流行病学方面、早期、偶然和晚期 GBC 管理、根治性 GBC 切除术的定义、肝切除术的范围、淋巴结清扫术，以及边界可切除和局部晚期 GBC 的定义。
这是首次关于 GBC 的国际德尔菲共识。这些建议提供了关于 GBC 现行管理的统一术语和实用临床指南。需要通过未来的临床研究来解决边界可切除/局部晚期 GBC 等有争议的未决问题。
