Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.

Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.

Gastric cancer is one of the most common cancers in both Korea and worldwide. Since 2004, the Korean Practice Guidelines for Gastric Cancer have been regularly updated, with the 4th edition published in 2022. The 4th edition was the result of a collaborative work by an interdisciplinary team, including experts in gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology, and guideline development methodology. The current guideline is the 5th version, an updated version of the 4th edition. In this guideline, 6 key questions (KQs) were updated or proposed after a collaborative review by the working group, and 7 statements were developed, or revised, or discussed based on a systematic review using the MEDLINE, Embase, Cochrane Library, and KoreaMed database. Over the past 2 years, there have been significant changes in systemic treatment, leading to major updates and revisions focused on this area.Additionally, minor modifications have been made in other sections, incorporating recent research findings. The level of evidence and grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation system. Key factors for recommendation included the level of evidence, benefit, harm, and clinical applicability. The working group reviewed and discussed the recommendations to reach a consensus. The structure of this guideline remains similar to the 2022 version.Earlier sections cover general considerations, such as screening, diagnosis, and staging of endoscopy, pathology, radiology, and nuclear medicine. In the latter sections, statements are provided for each KQ based on clinical evidence, with flowcharts supporting these statements through meta-analysis and references. This multidisciplinary, evidence-based gastric cancer guideline aims to support clinicians in providing optimal care for gastric cancer patients.

Background and Objectives: Post-thyroidectomy hematoma is reported in about 0.7%- 2.1% of patients who underwent thyroidectomy. A drain is frequently placed after surgery to prevent swelling and hematoma. This study aims to compare clinical differences and postoperative complications depending on the presence or absence of a drain, and to identify the factors affecting hematoma after thyroidectomy.Subjects and Method This is a retrospective study of patients who underwent conventional thyroidectomy from March 2019 to Jun 2023. We examined patient’s age, gender, underlying diseases, use of antithrombotic drug, surgery type, thyroid volume, length of hospital stay and postoperative complications (hematoma and vocal cord palsy) by examining medical records. Results: Of 587 patients enrolled in the study, the drain was placed in 369 (62.9%) patients, and not in 218 (37.1%) patients. The mean age, incidence of hypertension and Grave’s disease comorbidity, antithrombotic drug use, number of patients who underwent neck dissection, thyroid volume, operating time, and length of hospital stay were significantly higher in the drain placed group (p<0.05). But there was no significant difference in the ratio of vocal cord palsy and hematoma occurrence between the two groups. In logistic regression analysis, diabetes, the use of antithrombotic drugs, neck dissection, and larger thyroid volume were identified as risk factors for the occurrence of hematoma (p<0.05). Conclusion Surgeons tended to place the drain in patients with high bleeding tendency after thyroidectomy, but there was no difference in the incidence of hematoma according to drain placement. Rather, patients’ length of hospital stay increased due to the placement of drain.

Background and Objectives: Post-thyroidectomy hematoma is reported in about 0.7%- 2.1% of patients who underwent thyroidectomy. A drain is frequently placed after surgery to prevent swelling and hematoma. This study aims to compare clinical differences and postoperative complications depending on the presence or absence of a drain, and to identify the factors affecting hematoma after thyroidectomy.Subjects and Method This is a retrospective study of patients who underwent conventional thyroidectomy from March 2019 to Jun 2023. We examined patient’s age, gender, underlying diseases, use of antithrombotic drug, surgery type, thyroid volume, length of hospital stay and postoperative complications (hematoma and vocal cord palsy) by examining medical records. Results: Of 587 patients enrolled in the study, the drain was placed in 369 (62.9%) patients, and not in 218 (37.1%) patients. The mean age, incidence of hypertension and Grave’s disease comorbidity, antithrombotic drug use, number of patients who underwent neck dissection, thyroid volume, operating time, and length of hospital stay were significantly higher in the drain placed group (p<0.05). But there was no significant difference in the ratio of vocal cord palsy and hematoma occurrence between the two groups. In logistic regression analysis, diabetes, the use of antithrombotic drugs, neck dissection, and larger thyroid volume were identified as risk factors for the occurrence of hematoma (p<0.05). Conclusion Surgeons tended to place the drain in patients with high bleeding tendency after thyroidectomy, but there was no difference in the incidence of hematoma according to drain placement. Rather, patients’ length of hospital stay increased due to the placement of drain.

Background and Objectives: Post-thyroidectomy hematoma is reported in about 0.7%- 2.1% of patients who underwent thyroidectomy. A drain is frequently placed after surgery to prevent swelling and hematoma. This study aims to compare clinical differences and postoperative complications depending on the presence or absence of a drain, and to identify the factors affecting hematoma after thyroidectomy.Subjects and Method This is a retrospective study of patients who underwent conventional thyroidectomy from March 2019 to Jun 2023. We examined patient’s age, gender, underlying diseases, use of antithrombotic drug, surgery type, thyroid volume, length of hospital stay and postoperative complications (hematoma and vocal cord palsy) by examining medical records. Results: Of 587 patients enrolled in the study, the drain was placed in 369 (62.9%) patients, and not in 218 (37.1%) patients. The mean age, incidence of hypertension and Grave’s disease comorbidity, antithrombotic drug use, number of patients who underwent neck dissection, thyroid volume, operating time, and length of hospital stay were significantly higher in the drain placed group (p<0.05). But there was no significant difference in the ratio of vocal cord palsy and hematoma occurrence between the two groups. In logistic regression analysis, diabetes, the use of antithrombotic drugs, neck dissection, and larger thyroid volume were identified as risk factors for the occurrence of hematoma (p<0.05). Conclusion Surgeons tended to place the drain in patients with high bleeding tendency after thyroidectomy, but there was no difference in the incidence of hematoma according to drain placement. Rather, patients’ length of hospital stay increased due to the placement of drain.

Background and Objectives: Post-thyroidectomy hematoma is reported in about 0.7%- 2.1% of patients who underwent thyroidectomy. A drain is frequently placed after surgery to prevent swelling and hematoma. This study aims to compare clinical differences and postoperative complications depending on the presence or absence of a drain, and to identify the factors affecting hematoma after thyroidectomy.Subjects and Method This is a retrospective study of patients who underwent conventional thyroidectomy from March 2019 to Jun 2023. We examined patient’s age, gender, underlying diseases, use of antithrombotic drug, surgery type, thyroid volume, length of hospital stay and postoperative complications (hematoma and vocal cord palsy) by examining medical records. Results: Of 587 patients enrolled in the study, the drain was placed in 369 (62.9%) patients, and not in 218 (37.1%) patients. The mean age, incidence of hypertension and Grave’s disease comorbidity, antithrombotic drug use, number of patients who underwent neck dissection, thyroid volume, operating time, and length of hospital stay were significantly higher in the drain placed group (p<0.05). But there was no significant difference in the ratio of vocal cord palsy and hematoma occurrence between the two groups. In logistic regression analysis, diabetes, the use of antithrombotic drugs, neck dissection, and larger thyroid volume were identified as risk factors for the occurrence of hematoma (p<0.05). Conclusion Surgeons tended to place the drain in patients with high bleeding tendency after thyroidectomy, but there was no difference in the incidence of hematoma according to drain placement. Rather, patients’ length of hospital stay increased due to the placement of drain.

Background and Objectives: Post-thyroidectomy hematoma is reported in about 0.7%- 2.1% of patients who underwent thyroidectomy. A drain is frequently placed after surgery to prevent swelling and hematoma. This study aims to compare clinical differences and postoperative complications depending on the presence or absence of a drain, and to identify the factors affecting hematoma after thyroidectomy.Subjects and Method This is a retrospective study of patients who underwent conventional thyroidectomy from March 2019 to Jun 2023. We examined patient’s age, gender, underlying diseases, use of antithrombotic drug, surgery type, thyroid volume, length of hospital stay and postoperative complications (hematoma and vocal cord palsy) by examining medical records. Results: Of 587 patients enrolled in the study, the drain was placed in 369 (62.9%) patients, and not in 218 (37.1%) patients. The mean age, incidence of hypertension and Grave’s disease comorbidity, antithrombotic drug use, number of patients who underwent neck dissection, thyroid volume, operating time, and length of hospital stay were significantly higher in the drain placed group (p<0.05). But there was no significant difference in the ratio of vocal cord palsy and hematoma occurrence between the two groups. In logistic regression analysis, diabetes, the use of antithrombotic drugs, neck dissection, and larger thyroid volume were identified as risk factors for the occurrence of hematoma (p<0.05). Conclusion Surgeons tended to place the drain in patients with high bleeding tendency after thyroidectomy, but there was no difference in the incidence of hematoma according to drain placement. Rather, patients’ length of hospital stay increased due to the placement of drain.

Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Background: It is well known that a large number of patients with diabetes also have dyslipidemia, which significantly increases the risk of cardiovascular disease (CVD). This study aimed to evaluate the efficacy and safety of combination drugs consisting of metformin and atorvastatin, widely used as therapeutic agents for diabetes and dyslipidemia. Methods: This randomized, double-blind, placebo-controlled, parallel-group and phase III multicenter study included adults with glycosylated hemoglobin (HbA1c) levels >7.0% and <10.0%, low-density lipoprotein cholesterol (LDL-C) >100 and <250 mg/dL. One hundred eighty-five eligible subjects were randomized to the combination group (metformin+atorvastatin), metformin group (metformin+atorvastatin placebo), and atorvastatin group (atorvastatin+metformin placebo). The primary efficacy endpoints were the percent changes in HbA1c and LDL-C levels from baseline at the end of the treatment. Results: After 16 weeks of treatment compared to baseline, HbA1c showed a significant difference of 0.94% compared to the atorvastatin group in the combination group (0.35% vs. −0.58%, respectively; P<0.0001), whereas the proportion of patients with increased HbA1c was also 62% and 15%, respectively, showing a significant difference (P<0.001). The combination group also showed a significant decrease in LDL-C levels compared to the metformin group (−55.20% vs. −7.69%, P<0.001) without previously unknown adverse drug events. Conclusion The addition of atorvastatin to metformin improved HbA1c and LDL-C levels to a significant extent compared to metformin or atorvastatin alone in diabetes and dyslipidemia patients. This study also suggested metformin’s preventive effect on the glucose-elevating potential of atorvastatin in patients with type 2 diabetes mellitus and dyslipidemia, insufficiently controlled with exercise and diet. Metformin and atorvastatin combination might be an effective treatment in reducing the CVD risk in patients with both diabetes and dyslipidemia because of its lowering effect on LDL-C and glucose.