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Why should you receive treatment 
for biliary tract and pancreatic cancer at AMC?

Biliary tract and pancreatic cancers are generally known to have a poor prognosis compared to malignant tumors in other organs, and has a higher mortality rate than ten most common cancers despite low incidence. According to data published by the National Cancer Information Center, biliary tract and pancreatic cancers occurred in about 5,000 per 100,000 people, ranking eighth and ninth regarding prevalence respectively in 2013. However, they ranked fifth and sixth regarding mortality rates respectively in 2014, and the rates are expected to rise further. Biliary tract and pancreatic cancers do not have specific symptoms at an early stage and no effective methods for early screening. That’s why it hard to detect early enough for radical treatment and the prognosis is relatively unfavorable if advanced. Due to these characteristics, related specialties have to cooperate to treat biliary tract closely, and pancreatic cancers and the process of both diagnosis and treatment is becoming more sophisticated as diverse treatment approaches are developed. So, it is important to determine the optimal therapy through multidisciplinary collaboration, and it will ensure improved medical services according to a study. In line with the trend, the Biliary Tract & Pancreatic Cancer Center created a multidisciplinary treatment team in which related specialties share opinions and closely cooperate to produce the best treatment plan based on their clinical experiences and expertise. AMC has around 2,000 first-visit patients with biliary tract and pancreatic cancers and performs more than 800 surgeries for the cancers a year. The number of outpatients also doubled in five years. The statistical data shows that AMC is playing a significant role in the treatment of biliary tract and pancreatic cancers in Korea.

Treatment options

Department of Gastroenterology

1) ERCP (Endoscopic Retrograde Cholangiopancreatography)

This test uses endoscopy and radiation in combination. An endoscope is first inserted up to the duodenum, and a contrast medium is injected through the head of the duodenum where a medical instrument is inserted to examine the biliary duct and pancreatic duct. The biliary and pancreatic ducts are often occluded in many patients with biliary duct, and pancreatic cancers and its complications are treated with endoscopy.

2) EUS (Endoscopic Ultrasonography)

The biliary tract and pancreas are located deep inside the body, making it difficult to make accurate diagnosis with general tests. EUS is a medical instrument used to discover a lesion located deep inside by sending ultrasonic waves from the tip of an endoscope and remove tissue samples for examination and biopsy.

3) PTCS (Percutaneous Transhepatic Choledochoscopy)

This procedure inserts an endoscope into the biliary tract along a fistula that passes through the skin and the liver and examines and treats various diseases that occur in the biliary tract by using a contrast medium.

4) EUS intervention

Biliary tract and pancreatic tumors invade into adjacent organs (biliary tract and pancreas) to close off the biliary duct and pancreatic duct as the disease progresses, causing complications such as cholangitis, cholecystitis, and pancreatitis. In the past, the tumors that could not be accessed and cured with the ERCP were treated with the PTBD. Now, the EUS intervention is used to treat complications

AMC’s department of gastroenterology has performed more than 5,000 ERCP and EUS procedures by 2015, and carries out around 10,000 ERCP procedures a year on average, which is the largest amount in Korea.

Department of Oncology

Chemotherapy is increasingly used to treat biliary tract and pancreatic cancers, as part of multidisciplinary treatment provided in combination with radiotherapy and surgery especially for locally advanced cancers. The department of oncology offers world-class treatment to patients suffering from cancers with distant metastasis. Clinical studies of new drugs such as targeted and immune-oncologic agents are underway to provide better treatment. AMC’s department of oncology is conducting multiple clinical studies on novel immune-oncologic and targeted agents for biliary tract and pancreatic cancers in 2017. The studies are expected to improve treatment outcomes in patients with a metastatic biliary tract and pancreatic cancers.

Department of Radiation Oncology

AMC’s department of radiation oncology is the largest radiotherapy center in Korea that has world-class, state-of-the-art medical system and treats more than 5,000 patients per year. The department of radiation oncology is equipped with ten cutting-edge external beam radiation therapy machines including True Beam, TomoTherapy, and Cyber Knife as well as one brachytherapy treatment machine. Using these equipment, advanced high-precision special treatments such as stereotactic body radiation therapy, intensity modulated radiation therapy, volumetric modulated arc therapy, image guided radiation therapy, and respiratory gated radiation therapy are provided. The department is dedicated to offering optimal radiotherapy with minimized adverse effects and improved treatment outcomes based on the best experience and expertise in Korea.

AMC’s treatment performance

AMC’s department of surgery performs more than 3,000 hepatobiliary and pancreatic surgeries a year. AMC performs more than 1,800 minimally-invasive surgeries (laparoscopic or robot-assisted surgeries) and more than 1,500 highly-sophisticated surgeries (Whipple procedure and major hepatic resection) for hepatobiliary and pancreatic diseases per year, with low postoperative complications and mortality rates and high survival rates.