Randomized controlled trials on hepato-biliary-pancreatic surgery

The randomized controlled trial (RCT) plays an important role not only in the performance of evidence-based medicine but also in the establishment of therapeutic guidelines. In this review, I analyzed RCTs on hepato-biliary-pancreatic surgery, particularly on malignant diseases. The number of RCTs on hepato-biliary-pancreatic cancers is smaller than that on other types of cancers. This might be related to their low resectability. In liver surgery, a recent increase in RCTs of operative techniques has almost established a standard transection method. In biliary tract and pancreatic cancers, only a few RCTs have been performed concerning operative strategy. Therefore, many issues should be solved by an adequate RCT observing statements of the Consolidated Standards of Reporting Trials.