Purpose: Cystic duct cancers (CDCs) have been classified as extrahepatic bile duct cancers or gallbladder cancers (GBCs); however, it is unclear whether their clinical behavior is similar to that of distal extrahepatic bile duct cancers (DBDCs) or GBCs. Materials and Methods: T category of the CDCs was classified using current T category scheme of the GBCs and DBDCs, and clinicopathological factors were compared among 38 CDCs, 345 GBCs, and 349 DBDCs. We modified Nakata’s classifications (type 1, confined within cystic duct [CD]; combined types 2-4, extension beyond CD) and compared them. Results: No significant overall survival (OS) difference was observed between the patients with CDC, GBC, and DBDC. The T category of GBC staging was more accurate at distinguishing OS in patients with CDC than the DBDC staging. Patients with T3 CDC and GBC showed a significant OS difference when using the T category for GBC staging, while those with T1-T2 CDC and GBC showed no significant difference. In contrast, the T category of DBDC staging did not show any significant OS difference between patients with T1-T2 CDC and DBDC or T3 CDC and DBDC. Patients with type 1 CDC had significantly better OS than those with combined types. Conclusion Unlike GBCs and DBDCs, CDCs exhibit distinct clinicopathological characteristics. The OS is better when the CDC confines within the CD, compared to when it extends beyond it. Therefore, we propose a new T category scheme (T1, confined to CD; T2, invaded beyond CD) for better classifying CDCs.

Collective actions by physicians have occurred frequently worldwide, including in Korea.The literature primarily focuses on justifying industrial actions or assessing their impact on clinical outcomes. However, few studies have examined physicians’ actions in response to government health policies. A comprehensive review of this literature could provide valuable insights into how physicians can effectively address and resolve conflicts with governments.This study aimed to investigate the existing literature on physicians’ collective actions against government health policies and identify research gaps. A scoping review was conducted based on the methodology proposed by Arksey and O’Malley. We searched for terms related to physicians (e.g., doctors, trainees) and strikes (e.g., protests, walkouts) in PubMed, Embase, Scopus, Web of Science, KMbase, and RISS on March 25, 2024. A total of 5,248 articles published between 1974 and 2023 were screened, and 26 articles were selected for analysis. The authors of these studies were predominantly from the fields of social sciences, history, jurisprudence, and public health administration. Physician collective actions were documented in 16 countries across various levels of development. Physicians engaged in collective action for five main reasons: 1) Opposition to socialized medicine policies, 2) Opposition to healthcare privatization policies, 3) Dissatisfaction with poor or stagnant public healthcare systems and infrastructure, 4) Resistance to unreasonable medical reforms, and 5) Protests against inequitable health workforce policies. Government responses to physician strikes followed four main strategies: 1) Unilateral policy enforcement, 2) Instigation of conflicts, 3) Suppression of physicians through unwarranted use of governmental power, and 4) Use of mediators to negotiate resolutions. These strategies were employed regardless of whether the government was authoritarian or democratic. Physicians’ strategies against government policies were categorized as 1) Strengthening physician organizations, 2) Improving public relations, 3) Disrupting government policy implementation, and 4) Reducing the available medical workforce. In conclusion, this study highlights the need for more theory-based research and greater integration of social sciences into physicians’ education. We recommend that Korean physicians reflect on the strategies used by both governments and physicians in other countries and prepare for potential conflicts.

Collective actions by physicians have occurred frequently worldwide, including in Korea.The literature primarily focuses on justifying industrial actions or assessing their impact on clinical outcomes. However, few studies have examined physicians’ actions in response to government health policies. A comprehensive review of this literature could provide valuable insights into how physicians can effectively address and resolve conflicts with governments.This study aimed to investigate the existing literature on physicians’ collective actions against government health policies and identify research gaps. A scoping review was conducted based on the methodology proposed by Arksey and O’Malley. We searched for terms related to physicians (e.g., doctors, trainees) and strikes (e.g., protests, walkouts) in PubMed, Embase, Scopus, Web of Science, KMbase, and RISS on March 25, 2024. A total of 5,248 articles published between 1974 and 2023 were screened, and 26 articles were selected for analysis. The authors of these studies were predominantly from the fields of social sciences, history, jurisprudence, and public health administration. Physician collective actions were documented in 16 countries across various levels of development. Physicians engaged in collective action for five main reasons: 1) Opposition to socialized medicine policies, 2) Opposition to healthcare privatization policies, 3) Dissatisfaction with poor or stagnant public healthcare systems and infrastructure, 4) Resistance to unreasonable medical reforms, and 5) Protests against inequitable health workforce policies. Government responses to physician strikes followed four main strategies: 1) Unilateral policy enforcement, 2) Instigation of conflicts, 3) Suppression of physicians through unwarranted use of governmental power, and 4) Use of mediators to negotiate resolutions. These strategies were employed regardless of whether the government was authoritarian or democratic. Physicians’ strategies against government policies were categorized as 1) Strengthening physician organizations, 2) Improving public relations, 3) Disrupting government policy implementation, and 4) Reducing the available medical workforce. In conclusion, this study highlights the need for more theory-based research and greater integration of social sciences into physicians’ education. We recommend that Korean physicians reflect on the strategies used by both governments and physicians in other countries and prepare for potential conflicts.

Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

Purpose: Cystic duct cancers (CDCs) have been classified as extrahepatic bile duct cancers or gallbladder cancers (GBCs); however, it is unclear whether their clinical behavior is similar to that of distal extrahepatic bile duct cancers (DBDCs) or GBCs. Materials and Methods: T category of the CDCs was classified using current T category scheme of the GBCs and DBDCs, and clinicopathological factors were compared among 38 CDCs, 345 GBCs, and 349 DBDCs. We modified Nakata’s classifications (type 1, confined within cystic duct [CD]; combined types 2-4, extension beyond CD) and compared them. Results: No significant overall survival (OS) difference was observed between the patients with CDC, GBC, and DBDC. The T category of GBC staging was more accurate at distinguishing OS in patients with CDC than the DBDC staging. Patients with T3 CDC and GBC showed a significant OS difference when using the T category for GBC staging, while those with T1-T2 CDC and GBC showed no significant difference. In contrast, the T category of DBDC staging did not show any significant OS difference between patients with T1-T2 CDC and DBDC or T3 CDC and DBDC. Patients with type 1 CDC had significantly better OS than those with combined types. Conclusion Unlike GBCs and DBDCs, CDCs exhibit distinct clinicopathological characteristics. The OS is better when the CDC confines within the CD, compared to when it extends beyond it. Therefore, we propose a new T category scheme (T1, confined to CD; T2, invaded beyond CD) for better classifying CDCs.

Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

Collective actions by physicians have occurred frequently worldwide, including in Korea.The literature primarily focuses on justifying industrial actions or assessing their impact on clinical outcomes. However, few studies have examined physicians’ actions in response to government health policies. A comprehensive review of this literature could provide valuable insights into how physicians can effectively address and resolve conflicts with governments.This study aimed to investigate the existing literature on physicians’ collective actions against government health policies and identify research gaps. A scoping review was conducted based on the methodology proposed by Arksey and O’Malley. We searched for terms related to physicians (e.g., doctors, trainees) and strikes (e.g., protests, walkouts) in PubMed, Embase, Scopus, Web of Science, KMbase, and RISS on March 25, 2024. A total of 5,248 articles published between 1974 and 2023 were screened, and 26 articles were selected for analysis. The authors of these studies were predominantly from the fields of social sciences, history, jurisprudence, and public health administration. Physician collective actions were documented in 16 countries across various levels of development. Physicians engaged in collective action for five main reasons: 1) Opposition to socialized medicine policies, 2) Opposition to healthcare privatization policies, 3) Dissatisfaction with poor or stagnant public healthcare systems and infrastructure, 4) Resistance to unreasonable medical reforms, and 5) Protests against inequitable health workforce policies. Government responses to physician strikes followed four main strategies: 1) Unilateral policy enforcement, 2) Instigation of conflicts, 3) Suppression of physicians through unwarranted use of governmental power, and 4) Use of mediators to negotiate resolutions. These strategies were employed regardless of whether the government was authoritarian or democratic. Physicians’ strategies against government policies were categorized as 1) Strengthening physician organizations, 2) Improving public relations, 3) Disrupting government policy implementation, and 4) Reducing the available medical workforce. In conclusion, this study highlights the need for more theory-based research and greater integration of social sciences into physicians’ education. We recommend that Korean physicians reflect on the strategies used by both governments and physicians in other countries and prepare for potential conflicts.

Purpose: Cystic duct cancers (CDCs) have been classified as extrahepatic bile duct cancers or gallbladder cancers (GBCs); however, it is unclear whether their clinical behavior is similar to that of distal extrahepatic bile duct cancers (DBDCs) or GBCs. Materials and Methods: T category of the CDCs was classified using current T category scheme of the GBCs and DBDCs, and clinicopathological factors were compared among 38 CDCs, 345 GBCs, and 349 DBDCs. We modified Nakata’s classifications (type 1, confined within cystic duct [CD]; combined types 2-4, extension beyond CD) and compared them. Results: No significant overall survival (OS) difference was observed between the patients with CDC, GBC, and DBDC. The T category of GBC staging was more accurate at distinguishing OS in patients with CDC than the DBDC staging. Patients with T3 CDC and GBC showed a significant OS difference when using the T category for GBC staging, while those with T1-T2 CDC and GBC showed no significant difference. In contrast, the T category of DBDC staging did not show any significant OS difference between patients with T1-T2 CDC and DBDC or T3 CDC and DBDC. Patients with type 1 CDC had significantly better OS than those with combined types. Conclusion Unlike GBCs and DBDCs, CDCs exhibit distinct clinicopathological characteristics. The OS is better when the CDC confines within the CD, compared to when it extends beyond it. Therefore, we propose a new T category scheme (T1, confined to CD; T2, invaded beyond CD) for better classifying CDCs.

Purpose: This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer. Materials and Methods: A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery. Results: Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064). Conclusions Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.

Collective actions by physicians have occurred frequently worldwide, including in Korea.The literature primarily focuses on justifying industrial actions or assessing their impact on clinical outcomes. However, few studies have examined physicians’ actions in response to government health policies. A comprehensive review of this literature could provide valuable insights into how physicians can effectively address and resolve conflicts with governments.This study aimed to investigate the existing literature on physicians’ collective actions against government health policies and identify research gaps. A scoping review was conducted based on the methodology proposed by Arksey and O’Malley. We searched for terms related to physicians (e.g., doctors, trainees) and strikes (e.g., protests, walkouts) in PubMed, Embase, Scopus, Web of Science, KMbase, and RISS on March 25, 2024. A total of 5,248 articles published between 1974 and 2023 were screened, and 26 articles were selected for analysis. The authors of these studies were predominantly from the fields of social sciences, history, jurisprudence, and public health administration. Physician collective actions were documented in 16 countries across various levels of development. Physicians engaged in collective action for five main reasons: 1) Opposition to socialized medicine policies, 2) Opposition to healthcare privatization policies, 3) Dissatisfaction with poor or stagnant public healthcare systems and infrastructure, 4) Resistance to unreasonable medical reforms, and 5) Protests against inequitable health workforce policies. Government responses to physician strikes followed four main strategies: 1) Unilateral policy enforcement, 2) Instigation of conflicts, 3) Suppression of physicians through unwarranted use of governmental power, and 4) Use of mediators to negotiate resolutions. These strategies were employed regardless of whether the government was authoritarian or democratic. Physicians’ strategies against government policies were categorized as 1) Strengthening physician organizations, 2) Improving public relations, 3) Disrupting government policy implementation, and 4) Reducing the available medical workforce. In conclusion, this study highlights the need for more theory-based research and greater integration of social sciences into physicians’ education. We recommend that Korean physicians reflect on the strategies used by both governments and physicians in other countries and prepare for potential conflicts.