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

Source: https://onco.cc/key-papers/paper-jshbps-biliary-tract-cancer-guidelines-2019-jhbps-2021/  
OnCo record `paper-jshbps-biliary-tract-cancer-guidelines-2019-jhbps-2021` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Japan's surgical society guideline for bile duct, gallbladder and ampullary cancer, the only major guideline with a section on preventive treatment.

## Summary

Third English edition of the Japanese Society of Hepato-Biliary-Pancreatic Surgery guidelines, first issued in 2007 and revised in 2014. Thirty-one clinical questions cover six topics: prophylactic treatment, diagnosis, biliary drainage, surgical treatment, chemotherapy and radiation therapy, graded with GRADE as strong (14 recommendations) or weak (14), with three questions left without a recommendation.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: gallbladder-evidence
- Journal: Journal of Hepato-Biliary-Pancreatic Sciences
- Year: 2021
- DOI: 10.1002/jhbp.870
- Authors: Nagino M, Hirano S, Yoshitomi H, et al.
- Findings: 31 clinical questions across six topics including prophylactic treatment.; 14 strong and 14 weak recommendations; three questions with no recommendation.
- What it means: Japanese surgeons operate on gallbladder cancer far more often than UK surgeons and their guideline addresses prevention (pancreaticobiliary maljunction, polyps) as a clinical topic, which Western guidelines do not.
- Caveats: Surgical-society guideline; systemic therapy sections predate the immunotherapy trials.; Evidence for many surgical questions is retrospective.

## Sources

- J Hepatobiliary Pancreat Sci 2021: https://doi.org/10.1002/jhbp.870
- PubMed: https://pubmed.ncbi.nlm.nih.gov/33259690/

## Connected records

- cancers: [Ampullary cancer (ampulla of Vater)](https://onco.cc/cancers/ampullary/), [Biliary tract cancer (cholangiocarcinoma)](https://onco.cc/cancers/cholangiocarcinoma/), [Gallbladder cancer](https://onco.cc/cancers/gallbladder/)
- terms: [Prophylactic (preventive) cholecystectomy](https://onco.cc/terms/prophylactic-cholecystectomy/), [Radical (extended) cholecystectomy](https://onco.cc/terms/radical-cholecystectomy/)

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