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.