《法国胆道恶性肿瘤临床实践指南》解读  

Interpretation of biliary tract cancers: French national clinical practice guidelines for diagnosis,treatments and follow-up

作　　者：吴向嵩[1] 杨越 龚伟[1] WU Xiang-song;YANG Yue;GONG Wei(Department of General Surgery,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院普外科、上海交通大学医学院胆道疾病实验室、上海市胆道疾病研究重点实验室、上海市胆道疾病研究中心,上海200092

出　　处：《中国实用外科杂志》2024年第11期1246-1253,共8页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金项目(No.82172628,No.82173048,No.82373370);上海市卫生健康委员会卫生健康学科带头人项目(No.2022XD010);上海市科学技术委员会“科技创新行动计划”医学创新研究专项项目(No.22Y11908000)。

摘　　要：胆道恶性肿瘤恶性程度高、治疗效果不佳、预后差。2023年9月《法国胆道恶性肿瘤临床实践指南》发布,其英文版于2024年3月发表。该指南由法国12个医学或外科协会组成的多学科团队联合制定,对2023年8月前胆道恶性肿瘤相关诊治循证医学证据进行总结,针对肝内胆管癌、胆囊癌、肝门部胆管癌和远端胆管癌的临床实践进行详细阐述,其内容涵盖流行病学、诊断分型、外科治疗、药物治疗、放疗、随访等。该指南强调了胆管恶性肿瘤的个体化诊治原则及多科学讨论的重要性。但需注意的是,由于胆道恶性肿瘤的高质量临床研究数量有限,很多临床争议悬而未决,实际工作中结合具体情况决定病人诊疗方式,不能对指南生搬硬套。同时,该指南提及的争议也是将来开展高质量临床研究的重要方向。Biliary tract cancer(BTC)has an extremely high malignance with a poor prognosis.Biliary tract cancers:French national clinical practice guidelines for diagnosis,treatments and follow-up was released in September 2023,and its English version was published in March 2024.This guideline are collaborative work written by a multidisciplinary committee comprising experts from different specialties involved in the management of BTCs.It summarized the evidence-based medical evidence for the diagnosis and treatment of BTCs before August 2023,and provided a detailed elaboration of the clinical practice for intrahepatic cholangiocarcinoma,gallbladder cancer,hilar cholangio-carcinoma,and distal bile duct cancer.The content covered epidemiology,diagnosis and classification,surgical treatment,medication,radiotherapy,and follow-up.This guideline emphasized the principles of individualized medicine and the importance of multidisciplinary involvement in BTCs practice.Of note,due to the limited number of high-quality clinical trials on BTCs,many clinical controversies remain unresolved.Therefore,a personalized therapeutic strategy for daily clinical practice should be provided based on the actual situation and the blind application of these guidelines should be avoided.Meanwhile,the controversies mentioned in the guidelines also indicated possible directions for future high-quality clinical research.

关 键 词：胆道恶性肿瘤 胆管癌 胆囊癌 指南 解读 

分 类 号：R6[医药卫生—外科学]