Due to the unique location and aggressive tumor biology,hilar cholangiocarcinoma,intrahepatic cholangiocarcinoma,and gallbladder cancer often present with obstructive jaundice and require extensive liver resection,also exhibit high rates of recurrence and metastasis after radical excision. Therefore,surgeons should make treatment decisions based on the biliary anatomy of patients and the biological characteristics of tumors as it significantly affects patient's prognosis. Treatment strategy should be made to ensure the successful implementation of radical resection for biliary tract malignant tumors while maximizing the survival benefits of patients. Firstly,conversion of liver function by relieving jaundice technology and conversion of tumor biological characteristics through systematic therapy,followed by the conversion of future liver remnant. Currently,there are still controversies surrounding indications,methods,standards of relieving jaundice,and treatment plans,cycles,evaluation of therapeutic effects for systematic conversion therapy,and the standards and techniques of conversion therapy for future liver remnant.This article discusses these issues through literature analysis and the author's experience in the hope of resonating with colleagues.
肝门部胆管癌、肝内胆管癌、胆囊癌由于特殊的解剖部位和侵袭性强的肿瘤生物学特征，常表现出梗阻性黄疸、需行大范围肝切除、根治性切除后易复发和转移的特点，医师能否基于胆道恶性肿瘤患者的解剖学和生物学特征，制定科学的治疗决策，会显著影响患者的预后。以减黄技术实现肝功能转化和以系统治疗方式实现肿瘤生物学特性转化为先，余肝体积转化为后的治疗策略，是安全实施胆道恶性肿瘤根治性切除术、使患者有满意生存获益的关键。目前对减黄治疗的适应证、方式、标准，以及系统转化治疗方案、周期、疗效评估，余肝体积转化标准、转化技术仍有争议，本文结合文献报道和作者经验，对这些问题予以论述，期望与同道共同探讨。.