Guidelines for the Diagnosis and Management of Cholangiocarcinoma

Commissioned by the British Society of Gastroenterology (BSG), and published in GUT in September 2023, these are the most comprehensive guidelines for the diagnosis and management of cholangiocarcinoma (CCA) since 2012.

Headed by Professor Shahid Khan, the guidelines were prepared by a multidisciplinary writing committee* of UK experts from various specialties involved in the diagnosis and management of CCA – including Helen Morement from AMMF – each writing a section on their own area of expertise.

The aim of the guidelines is to update and assist clinicians in the diagnosis and management of patients with CCA.  Recommendations are noted in every area based on a set format using best available evidence and experience. 

Included in the guidelines is the recommendation that the management of CCA should be undertaken at centres with expertise across all relevant specialties, including surgery, interventional radiology, endoscopy, hepatobiliary medicine, oncology and pathology.  The management of patients with CCA is often complex and always requires individual patient-centred considerations, so the guidelines also note that all those diagnosed with CCA should be discussed at multidisciplinary team (MDT) meetings and should be classified as best as possible into one of the three types of CCA,  intrahepatic, perihilar or distal/extrahepatic.

Both specialist MDTs and CCA Centres of Expertise are high on AMMF’s priority project list

Also included in the guidelines are recommendations around diagnostics, molecular profiling, targeted therapies, surgery, stenting, liver transplantation, and more.

Although primarily aimed at clinicians, CCA patients could share this document with their care team to ensure they are following the most up to date procedures.  

*The multidisciplinary writing committee:
Shahid A Khan, Simon M Rushbrook, Timothy James Kendall, Yoh Zen, Raneem Albazas, Prakash Manoharan, Stephen P Pereira, Richard Sturgess, Brian R Davidson, Hassan Z Malik, Derek Manas, Nigel Heaton, K Raj Prasad, John Bridgewater, Juan W Valle, Rebecca Goody, Maria Hawkins, Wendy Prentice, Helen Morement, Martine Walmsley

To download the Guidelines from Gut, go to:

September 2023