Waiting for UK Guidelines

Guidelines for the Diagnosis and Treatment of CC in the UK – An Update

(or an update on the update …)

For the first time in ten years, the Guidelines for the Diagnosis and Treatment of Cholangiocarcinoma in the UK have been updated by a group of GI specialists*.  These are evidence based Guidelines, and the focus is on currently available medical literature.

The intention is that these Guidelines will be circulated to all specialist doctors and nurses in the field: hepatobiliary medicine/endoscopy/surgery, hepatology/GI physicians and surgeons, and GI cancer specialists.

The Guidelines were submitted to the British Society of Gastroenterology (BSG) mid 2011, and circulated for peer review nationally.  Also, although this document is highly technical and written for very specialised professionals, because the BSG is keen to have some patient input, last September AMMF was asked to review the Guidelines from a layman/patient’s perspective, which we duly did.

We have been waiting to hear the date the Guidelines will be published in the journal Gut so we can put the full document on AMMF’s website – and have just asked for an update on this from Dr Shahid Khan, lead on the Guidelines group.

He replied that the international reviewers to whom the journal Gut sent the manuscript (even though it had already been approved by the British Society of Gastroenterology) have come back with many pages of comments to be answered point by point. A considerable amount of work which, when done, will then be sent back to the journal, who will send back it to the reviewers who will then, hopefully, be satisfied. It will then go back to the journal Gut, who will (again, hopefully) accept the guidelines for publication.  And then it will probably be another few months before it is actually in print!

As Dr Khan commented, “Unfortunately this is the pace of modern medical research!”


*The group: Shahid A. Khan, Brian R. Davidson, Robert Goldin, Nigel Heaton, John Karani, Stephen P. Pereira, William M. C. Rosenberg, Simon D. Taylor-Robinson, Paul Tait, Andrew V. Thillainayagam, Howard C. Thomas, Harpreet Wasan

Hepatology and Gastroenterology Section (S.A. Khan, S.D Taylor-Robinson, A. Thillainayagam, H.C. Thomas), Department of Medicine and Department of Histopathology (R. Goldin), Imperial College London, St Mary’s Hospital Campus, South Wharf Road, London W2 1NY, United Kingdom; Department of Oncology (H. Wasan), Imperial College London Hammersmith Hospital Campus, Du Cane Road, London W12 OHS; Department of Hepatobiliary Surgery (B.R. Davidson) and University College London Centre for Hepatology (S.P. Pereira, W.M.C. Rosenberg), Division of Medicine, University College London, Royal Free and University College Medical School, Pond Street, London, London, NW3 2QG; Department of  Hepatobiliary and Pancreatic Surgery (N. Heaton, P. Karani), King’s College Hospital, Denmark Hill, London, SE5 9RS.

(info posted 19.03.12)

Bookmark and Share
This entry was posted in News. Bookmark the permalink.

2 Responses to Waiting for UK Guidelines

  1. Stewart Ibbotson says:

    It is essential that the medical profession don’t go down the closed route and open up the GP’s to alternative diagnosises for symptoms of Jaundice a usual sign of Bile Duct blockage. Gall stones ok, but Obstructive Jaundice gives a more open idea and would lead to examination including ERCP and EUS. This could lead to an early diagnosis and possible surgery before metastases takes place. I for one believe that the change in my diagnosis from Gall Stones to Obstructive Jaundice, and the fact I gave the go ahead for Whipples before the biopsy came back, saved valuable time and maybe saved my life.

  2. helen says:

    You were so fortunate to be diagnosed and treated so promptly, Stewart – but the question you have raised is a really difficult one. So many GP’s would not think along these lines at all – and we have been told that the new updated Guidelines (when we eventually get them) will not be circulated to GP’s because “the document is highly technical and written for very specialised professionals.”

    So how do we raise awareness amongst GP’s? Especially when symptoms can be varied and could be attributed to any number of conditions, and when referrals are being limited …

Leave a Reply

Your email address will not be published. Required fields are marked *