【医脉通-指南】2015+AHPBA专家共识声明：肝内胆管癌.pdfVIP

DOI:10.1111/hpb.12441 HPB ORIGINAL ARTICLE Intrahepatic Cholangiocarcinoma: expert consensus statement Sharon M. Weber1, Dario Ribero2, Eileen M. O’Reilly3, Norihiro Kokudo4, Masaru Miyazaki5 Timothy M. Pawlik6 1Department of Surgery, University of Wisconsin, Madison, WI, USA, 2Department of General Surgery and Surgical Oncology, Mauriziano ‘Umberto I’ Hospital, Turin, Italy, 3Department of Medical Oncology, Memorial Sloan–Kettering Cancer Center, New York, NY, USA, 4Hepato-Biliary-Pancreatic Surgery Division, Arti?cial Organ and Liver Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan, 5Department of Surgery, Chiba University Graduate School of Medicine, Chiba, Japan, and 6Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA Abstract An American Hepato-Pancreato-Biliary Association (AHPBA)-sponsored consensus meeting of expert panellists met on 15 January 2014 to review current evidence on the management of intrahepatic cholangiocarcinoma (ICC) in order to establish practice guidelines and to agree on consensus state- ments. The treatment of ICC requires a coordinated, multidisciplinary approach to optimize survival. Biopsy is not necessary if the surgeon suspects ICC and is planning curative resection, although biopsy should be obtained before systemic or locoregional therapies are initiated. Assessment of resectability is best accomplished using cross-sectional imaging [computed tomography (CT) or magnetic resonance imaging (MRI)], but the role of positron emission tomography (PET) is unclear. Resectability in ICC is de?ned by the ability to completely remove the disease while leaving an adequate liver remnant. Extrahepatic disease, multiple bilobar or multicentric tumours, and lymph node metastases beyond the primary echelon are contraindicatio