'IHPBA-APHPBA clinical practice guidelines': international Delphi consensus recommendations for gallbladder cancer

Area of Science:

• Hepatobiliary Surgery
• Oncology
• Clinical Practice Guidelines

Background:

• Gallbladder cancer (GBC) management requires standardized global practice guidelines.
• The International and Asia-Pacific Hepato-Pancreato-Biliary Associations (IHPBA-APHPBA) initiated a Delphi consensus study.
• The study aimed to develop globally applicable GBC management guidelines.

Purpose of the Study:

• To establish international consensus on gallbladder cancer (GBC) management.
• To develop uniform terminology and practical clinical guidelines for GBC.
• To address key aspects of GBC diagnosis and treatment.

Main Methods:

• A four-round hybrid Delphi consensus process involving 45 experts from 17 countries.
• Utilized email, online consultations, and in-person discussions for expert input.
• Administered 68 clinical questions (CQs) related to GBC management.

Main Results:

• Consensus was achieved on 92.6% (63/68) of clinical questions.
• Recommendations cover GBC epidemiology, management of early, incidental, and advanced stages.
• Defined radical resection extent, liver resection, lymph node dissection, and borderline resectable GBC.

Conclusions:

• This is the first international Delphi consensus providing unified GBC management guidelines.
• The recommendations establish standardized terminology and practical clinical approaches for GBC.
• Further research is needed for contentious issues like borderline resectable and locally advanced GBC.