欧洲肝脏研究协会及国际肝癌协会2023版《肝内胆管癌治疗临床实践指南》更新解读

Interpretation of the updates in 2023 EASL-ILCA Clinical Practice Guidelines on the management of intrahepatic cholangiocarcinoma

欧洲肝脏研究协会(EASL)及国际肝癌协会(ILCA)于2023年发布最新的《肝内胆管癌治疗临床实践指南》(简称新版指南)。相较于EASL-ILCA在2014年发布的上一版本指南(简称旧版指南),新版指南采取了全新的问题导向式文章架构,精准聚焦肝内胆管癌(iCCA)领域亟待回答的关键临床问题,尤其是旧版指南未包括的或需要根据最新科学研究进展加以更新的问题。针对这些问题,新版指南提出对应的推荐意见,在分类、风险因素、诊断、分期及治疗等方面对iCCA的临床诊疗指导意见进行了大幅更新。本文旨在对EASL-ILCA新版指南的更新要点进行详细解读,并结合国内外现有iCCA指南的相关内容进行比较和讨论,希望不断促进胆道外科医师对iCCA临床诊疗实践的深入理解。

In 2023,the European Association for the Study of the Liver(EASL)and the International Liver Cancer Association(ILCA)released the latest version of the"Clinical Practice Guidelines on the Management of Intrahepatic Cholangiocarcinoma"(referred to as"new version guidelines").In comparison to the previous version of guidelines developed by EASL-ILCA in 2014(referred to as"old version guidelines"),the new version guidelines adopt a new question-oriented article structure,accurately focusing on crucial clinical questions that urgently need to be answered in the field of intrahepatic cholangiocarcinoma(iCCA),especially those that are not covered by the old version guidelines or need to be updated based on recent scientific progress.In response to these questions,the new version guidelines proposed corresponding recommendations,providing substantial updates to clinical guidance for iCCA in respect of classification,risk factors,diagnosis,staging,and treatment.The purpose of this article is to provide a detailed interpretation of the key updates in the EASL-ILCA new version guidelines,and also to compare and discuss the relevant content of existing iCCA guidelines worldwide.Hopefully,it can continuously promote our in-depth understanding in the clinical practice of iCCA diagnosis and treatment.