Chinese multicenter expert consensus on the diagnosis and treatment of hilar cholangiocarcinoma: 2025 edition.

Abstract

Hilar cholangiocarcinoma (hCCA) is a malignant tumor originating from the epithelial cells of the bile ducts, and it is characterized by an aggressive nature, complex surgical management, high mortality, and poor prognosis. Despite recent advances in surgical techniques, medical devices, and related technologies, there remains a pressing need to standardize diagnostic and therapeutic pathways to improve treatment outcomes and extend long-term patient survival. To better integrate and refine these standards, this consensus was reached through a national conference held in Changsha, Hunan Province, involving multidisciplinary experts from various regions across China. This collaborative effort, drawing from various medical facilities and academic organizations nationwide, resulted in the reaching of the "Chinese Multicenter Expert Consensus on the Diagnosis and Treatment of Hilar Cholangiocarcinoma: 2025 Edition" based on current clinical studies and over 40 years of clinical practice experience in managing hCCA. The consensus provides a comprehensive overview of hCCA, including its epidemiological characteristics, diagnostic and screening methods, pathological features, staging and classification systems, and various treatment modalities, while offering specific and actionable recommendations for clinical practice that highlight well-defined indications for surgical, local, and systemic therapies and that emphasize the importance of multidisciplinary approaches to both diagnostic and therapeutic workflows.