Clinical practice guidelines for the management of biliary tract cancers 2019: The 3rd English edition

Masato Nagino, Satoshi Hirano, Hideyuki Yoshitomi, Taku Aoki, Katsuhiko Uesaka, Michiaki Unno, Tomoki Ebata, Masaru Konishi, Keiji Sano, Kazuaki Shimada, Hiroaki Shimizu, Ryota Higuchi, Toshifumi Wakai, Hiroyuki Isayama, Takuji Okusaka, Toshio Tsuyuguchi, Yoshiki Hirooka, Junji Furuse, Hiroyuki Maguchi, Kojiro SuzukiHideya Yamazaki, Hiroshi Kijima, Akio Yanagisawa, Masahiro Yoshida, Yukihiro Yokoyama, Takashi Mizuno, Itaru Endo

Research output: Contribution to journalArticlepeer-review

57 Citations (Scopus)


Background: The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014. Methods: In this 3rd version, clinical questions (CQs) were proposed on six topics. The recommendation, grade for recommendation, and statement for each CQ were discussed and finalized by an evidence-based approach. Recommendations were graded as Grade 1 (strong) or Grade 2 (weak) according to the concepts of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results: The 31 CQs covered the six topics: (a) prophylactic treatment, (b) diagnosis, (c) biliary drainage, (d) surgical treatment, (e) chemotherapy, and (f) radiation therapy. In the 31 CQs, 14 recommendations were rated strong and 14 recommendations weak. The remaining three CQs had no recommendation. Each CQ includes a statement of how the recommendations were graded. Conclusions: This latest guideline provides recommendations for important clinical aspects based on evidence. Future collaboration with the cancer registry will be key for assessing the guidelines and establishing new evidence.

Original languageEnglish
Pages (from-to)26-54
Number of pages29
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Issue number1
Publication statusPublished - 2021 Jan


  • biliary tract cancer
  • clinical practice
  • guideline

ASJC Scopus subject areas

  • Surgery
  • Hepatology


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