《肝门部胆管癌：米兰专家共识》解读

Interpretation of Recommendations on Perihilar Cholangiocarcinoma. The Milan Jury-Based Consensus

摘要:

2025年6月发布的《肝门部胆管癌：米兰专家共识》由全球71位专家组成8个工作组，基于570项研究，采用苏黎世—丹麦共识模型，结合GRADE证据分级体系及《牛津循证医学中心证据分级（2011版）》制定，形成71条推荐意见，旨在为肝门部胆管癌（pCCA）的规范化诊治提供循证依据，并明确未来研究方向。该共识系统涵盖pCCA的定义与诊断、术前评估与优化、手术策略、肝移植适应证及结局报告标准等关键问题，尤其聚焦外科治疗中的争议焦点及决策路径。本文结合国内外相关指南及作者临床实践经验，对共识的核心推荐进行系统梳理与对比解读，以期为临床医师理解与应用该共识提供参考。

Abstract:

The Recommendations on Perihilar Cholangiocarcinoma. The Milan Jury-Based Consensus, published in June 2025, was developed by 71 international experts organized into eight working groups. Based on the review of 570 studies, the consensus was formulated using the Zurich–Danish model in combination with the GRADE methodology and the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. A total of 71 recommendations were established to standardize the diagnosis and management of perihilar cholangiocarcinoma (pCCA) and to identify priorities for future research. The consensus comprehensively addresses key aspects of pCCA management, including definition and diagnostic strategies, preoperative assessment and optimization, surgical resection, liver transplantation, and standardized outcome reporting. Particular emphasis is placed on controversial issues in surgical management and decision-making algorithms. In this article, we systematically interpret the core recommendations of the consensus and compare them with existing domestic and international guidelines, integrating relevant clinical experience, in order to facilitate their understanding and implementation in clinical practice.