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Guidelines for the diagnosis and treatment of cholangiocarcinoma: an update

Gut 2012; 61:1657–1669. doi:10.1136/gutjnl-2011-301748

Khan SA, Davidson BR, Goldin RD, Heaton N, Karani J, Pereira SP, Rosenberg WMC, Tait P, Taylor-Robinson SD, Thillainayagam AV, Thomas HC, Wasan H

Abstract

The British Society of Gastroenterology guidelines on the management of cholangiocarcinoma were originally published in 2002. This is the first update since then and is based on a comprehensive review of the recent literature, including data from randomised controlled trials, systematic reviews, meta-analyses, cohort, prospective and retrospective studies.

Development of guidelines

These guidelines on the management of cholangiocarcinoma (CC) were originally published in 2002. This is the first update since and is based on a comprehensive review of the recent literature. The recent European HepatoPancreatoBiliary Association Consensus Conference on Cholangiocarcinoma guidelines have also been used as a source. Specific recommendations have been graded based on the quality of evidence available. In the absence of significant data, evidence was based on expert opinion. This manuscript has been developed with the support of The British Liver Trust and the UK cholangiocarcinoma charity, the Alan Morement Memorial Fund.

Intent

These guidelines are intended to bring consistency and improvement in the management from first suspicion of CC through to diagnosis and subsequent treatment. As stated in other British Society of Gastroenterology guidelines, patient preferences must be sought and decisions made jointly by the patient and health professional, based on the risks and benefits of any intervention. A multidisciplinary team approach is recommended, and these often complex cases should be managed in specialist centres with the relevant experience. The guidelines should not necessarily be regarded as the standard of care for all patients. Each case must be managed on the basis of individual clinical data.



2002 Guideline

To provide context the 2002 guideline is included below:

Khan SA, Davidson BR, Goldin RD, Pereira SP, Rosenberg WMC, Taylor-Robinson SD, Thillainayagam AV, Thomas HC, Thursz MR, Wasan H

Introduction

The need for these guidelines was highlighted following the annual meeting of the British Association for the Study of the Liver (BASL) in September 2000. During their development these guidelines were presented at a BASL Liver CancerWorkshop in January 2001. They were also circulated to BASL members and the Liver Section of the British Society of Gastroenterology (BSG) Committee members, including gastroenterologists, hepatologists, gastroenterological surgeons, pathologists, radiologists, and epidemiologists for comments before the final consensus document was drawn up.