胆囊癌诊断和治疗指南(2019版)

Guideline for the diagnosis and treatment of gallbladder carcinoma(2019 edition)

为提高我国胆囊癌总体治疗效果,中华医学会外科学分会胆道外科学组、中国医师协会胆道外科专业委员会制订了《胆囊癌诊断和治疗指南(2019版)》。该指南明确了胆囊癌发病的危险因素及干预方法、随访流程,描述了胆囊癌TNM最新分期,并提出了胆囊癌的临床分型。基于现代高质量影像技术和内镜技术可精准评估胆囊癌分期和分型,对进展期胆囊癌应贯彻综合治疗的理念,进行多学科讨论,科学决策治疗手段。胆囊癌的外科治疗应在具有丰富经验的肝胆胰外科医师和病理科医师的医疗中心完成,合理选择手术技术平台,实施规范的胆囊癌根治性切除术;化疗、放疗、靶向治疗及免疫治疗的结合应用可改善胆囊癌患者的预后,但仍需进一步研究使胆囊癌患者获得更大生存获益。

In order to improve the overall therapeutic effect of gallbladder cancer in China,Branch of Biliary Surgery,Chinese Surgical Society and Chinese Committee of Biliary Surgeons have formulated the guideline for the diagnosis and treatment of gallbladder carcinoma(2019 edition).The guideline provided an overview of the evidence on epidemiological risk factors,treatment and follow-up strategies for patients with gallbladder cancer.It also updated the new TNM stage and proposed the clinical classification of gallbladder cancer for the first time.The guideline highlighted the importance of accurate prediction of TNM stage and type of gallbladder cancer based on modern high-quality imaging technology and endoscopic techniques.The idea of comprehensive treatment should be established as the fundamental principle for patients with advanced gallbladder cancer,and a multidisciplinary approach is recommended to make optimal clinical decisions.Standard radical surgical treatment should be delivered by a team of experienced hepato-pancreato-biliary surgeons and pathologists.The combination regimens of chemotherapy,radiotherapy,targeted therapy and immunotherapy for gallbladder cancer have shown promise in improving prognosis.Further research is still needed to confer greater survival benefits to patients with gallbladder cancer.