《英国胃肠病学会胆管癌诊治指南(2023版)》更新解读  

Interpretation of the Updated British Society of Gastroenterology Guidelines for the diagnosis and treatment of cholangiocarcinoma(2023 Edition)

作　　者：刘洋 阮祥 段安琪 陆凯 张永杰 俞文隆 王向 LIU Yang;RUAN Xiang;DUAN An-qi;WANG Xiang;YU Wen-long(Department of Biliary SurgeryⅡ,the Third Affiliated Hospital(Eastern Hepatobiliary Surgery Hospital)of Naval Medical University,Shanghai 200438,China)

机构地区：[1]海军军医大学第三附属医院(东方肝胆外科医院)胆道二科,上海200438

出　　处：《中国实用外科杂志》2024年第3期292-299,311,共9页Chinese Journal of Practical Surgery

基　　金：上海市青年科技英才扬帆计划项目(No.21YF1458500);国家自然科学基金项目(No.82203209);中国博士后科学基金项目(No.2022M720786)。

摘　　要：2022年英国胃肠病学会肝脏分会召集胆管癌研究领域的多学科专家,基于近年来的循证医学证据,从胆管癌诊治的各个层面,包括流行病学、病理学、影像学诊断、内镜检查、手术治疗、系统治疗、放射治疗等,较全面地更新了该协会2012年版的胆管癌诊疗指南。指南分类提出了50条推荐意见并进行了详细阐释。然而,鉴于胆管癌病情复杂、治疗方案多样、高级别循证医学证据不足,加之不同个体之间具有较强的临床和分子异质性,故该指南所提建议应作为一般指导原则而非机械照搬的准则,并应结合中国国情应用。该指南为制定高质量胆道外科循证指南提供了范例,指南列出的低-中级别循证医学证据及争议问题也为胆管癌研究指明了未来重点突破的方向。In 2022,the Liver Section of the British Society of Gastroenterology convened a panel of multidisciplinary experts in the field of cholangiocarcinoma research.Based on recent evidence-based medical data,the panel comprehensively updated the guidelines for the diagnosis and treatment of cholangiocarcinoma.These updates cover a multitude of facets,including epidemiology,pathology,imaging diagnostics,endoscopic examination,surgical treatment,systemic treatment,and radiation therapy.This revision is built upon the Association's 2012 version of the guidelines,outlining 50 recommendations,each accompanied by a detailed explanation.However,given the complexity of cholangiocarcinoma,the diversity of treatment options,and the lack of high-level medical evidence,coupled with the pronounced clinical and molecular heterogeneity among individuals,the recommendations put forth in these guidelines should be viewed as general guiding principles rather than inflexible rules.Application of these guidelines should consider the specific national conditions of China.This guideline serves as a model for formulating high-quality,evidence-based guidelines for biliary surgery.The listing of low-to-medium-level medical evidence and contentious issues within these guidelines also provides direction for future key breakthroughs in cholangiocarcinoma research.These guidelines provide a clear and concise overview while acknowledging the need for flexibility and adaptation in their application.

关 键 词：胆管癌 胆管恶性梗阻 临床指南 循证医学 

分 类 号：R6[医药卫生—外科学]