Randomized controlled trials on hepato-biliary-pancreatic surgery.

Area of Science:

• Hepatobiliary and Pancreatic Surgery
• Oncology
• Clinical Trials

Background:

• Randomized controlled trials (RCTs) are fundamental for evidence-based medicine and therapeutic guideline development.
• Hepato-biliary-pancreatic (HBP) surgery, especially for malignant diseases, has a limited number of published RCTs compared to other cancer types.
• Low resectability rates in HBP cancers may contribute to the scarcity of RCTs.

Purpose of the Study:

• To review and analyze the existing randomized controlled trials (RCTs) in hepato-biliary-pancreatic surgery, focusing on malignant conditions.
• To identify gaps in the literature regarding RCTs for HBP cancers and highlight areas needing further investigation.
• To emphasize the importance of adhering to reporting standards like the Consolidated Standards of Reporting Trials (CONSORT) for future RCTs.

Main Methods:

• Systematic review and analysis of published randomized controlled trials (RCTs) in the field of hepato-biliary-pancreatic surgery.
• Focus on studies addressing malignant diseases within the liver, biliary tract, and pancreas.
• Evaluation of the quantity and quality of RCTs, particularly concerning operative techniques and strategies.

Main Results:

• A notable increase in RCTs for operative techniques in liver surgery has led to the establishment of standard transection methods.
• There is a significant paucity of RCTs addressing operative strategies for biliary tract and pancreatic cancers.
• The overall number of RCTs in HBP cancers is lower than in other oncological fields, potentially due to challenges in resectability.

Conclusions:

• While liver surgery has seen progress in establishing standard techniques through RCTs, biliary tract and pancreatic cancers require more rigorous research.
• Further high-quality RCTs adhering to CONSORT guidelines are essential to address unresolved issues and optimize surgical strategies in HBP oncology.
• The review underscores the need for increased research efforts to improve evidence-based practice in the surgical management of HBP malignancies.