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dc.contributor.authorRungsun Rerknimitren_US
dc.contributor.authorPhonthep Angsuwatcharakonen_US
dc.contributor.authorThawee Ratanachu-eken_US
dc.contributor.authorChristopher J.L. Khoren_US
dc.contributor.authorRyan Ponnuduraien_US
dc.contributor.authorJong Ho Moonen_US
dc.contributor.authorDong Wan Seoen_US
dc.contributor.authorLinda Pantongrag-Brownen_US
dc.contributor.authorApichat Sangchanen_US
dc.contributor.authorPises Pisespongsaen_US
dc.contributor.authorThawatchai Akaraviputhen_US
dc.contributor.authorNageshwar D. Reddyen_US
dc.contributor.authorAmit Maydeoen_US
dc.contributor.authorTakao Itoien_US
dc.contributor.authorNonthalee Pausawasdien_US
dc.contributor.authorSundeep Punamiyaen_US
dc.contributor.authorSiriboon Attasaranyaen_US
dc.contributor.authorBenedict Devereauxen_US
dc.contributor.authorMohan Ramchandanien_US
dc.contributor.authorKhean Lee Gohen_US
dc.contributor.otherChulalongkorn Universityen_US
dc.contributor.otherRajavithi Hospitalen_US
dc.contributor.otherFaculty of Medicine, Ramathibodi Hospital, Mahidol Universityen_US
dc.contributor.otherMahidol Universityen_US
dc.contributor.otherKhon Kaen Universityen_US
dc.contributor.otherFaculty of Medicine, Chiang Mai Universityen_US
dc.contributor.otherPrince of Songkla Universityen_US
dc.contributor.otherNational University Health Systemen_US
dc.contributor.otherTan Tock Seng Hospitalen_US
dc.contributor.otherPrince Court Medical Centreen_US
dc.contributor.otherUniversity of Malayaen_US
dc.contributor.otherSoonchunhyang University, College of Medicineen_US
dc.contributor.otherUniversity of Ulsan, College of Medicineen_US
dc.contributor.otherAsian Institute of Gastroenterology Indiaen_US
dc.contributor.otherInstitute of Advanced Endoscopyen_US
dc.contributor.otherTokyo Medical Universityen_US
dc.contributor.otherRoyal Brisbane and Women's Hospitalen_US
dc.identifier.citationJournal of Gastroenterology and Hepatology (Australia). Vol.28, No.4 (2013), 593-607en_US
dc.description.abstractHilar cholangiocarcinoma (HCCA) is one of the most common types of hepatobiliary cancers reported in the world including Asia-Pacific region. Early HCCA may be completely asymptomatic. When significant hilar obstruction develops, the patient presents with jaundice, pale stools, dark urine, pruritus, abdominal pain, and sometimes fever. Because no single test can establish the definite diagnosis then, a combination of many investigations such as tumor markers, tissue acquisition, computed tomography scan, magnetic resonance imaging/magnetic resonance cholangiopancreatography, endoscopic ultrasonography/intraductal ultrasonography, and advanced cholangioscopy is required. Surgery is the only curative treatment. Unfortunately, the majority of HCCA has a poor prognosis due to their advanced stage on presentation. Although there is no survival advantage, inoperable HCCA managed by palliative drainage may benefit from symptomatic improvement. Currently, there are three techniques of biliary drainage which include endoscopic, percutaneous, and surgical approaches. For nonsurgical approaches, stent is the most preferred device and there are two types of stents i.e. plastic and metal. Type of stent and number of stent for HCCA biliary drainage are subjected to debate because the decision is made under many grounds i.e. volume of liver drainage, life expectancy, expertise of the facility, etc. Recently, radio-frequency ablation and photodynamic therapy are promising techniques that may extend drainage patency. Through a review in the literature and regional data, the Asia-Pacific Working Group for hepatobiliary cancers has developed statements to assist clinicians in diagnosing and managing of HCCA. After voting anonymously using modified Delphi method, all final statements were determined for the level of evidence quality and strength of recommendation. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.en_US
dc.rightsMahidol Universityen_US
dc.titleAsia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinomaen_US
Appears in Collections:Scopus 2011-2015

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