Cholangiocarcinoma refers to malignant tumors occurring in the lining epithelium of the bile duct system. Intrahepatic cholangiocarcinoma originates from the lining epithelium of any part of the intrahepatic bile duct and its branches to the interlobular bile duct tree; extrahepatic cholangiocarcinoma is divided into cholangiocarcinoma of the hilar region and distal cholangiocarcinoma based on the confluence of the cystic duct and common hepatic duct. In recent years, the incidence of cholangiocarcinoma has been increasing year by year. These three types of cholangiocarcinoma with different anatomical locations have their own TNM staging. In view of the current situation, it is necessary to develop a diagnosis and treatment standard for cholangiocarcinoma suitable for China’s national conditions. 1. Risk factors of bile duct cancer The causes of bile duct cancer are still unclear. The risk factors for the development of bile duct cancer reported in literature include advanced age, bile duct stones, bile duct adenoma and bile duct papillomatosis, Caroli disease, common bile duct cyst, viral hepatitis, liver cirrhosis, primary sclerosing cholangitis (PSC), ulcerative colitis, chemical toxins, smoking, and Schistosoma haematobium or Schistosoma chinense infection. 2.Surgical treatment Surgical resection is the first choice of treatment for bile duct cancer. As long as bile duct cancer can be resected radically, the patient’s general condition can tolerate it and there is no distant metastasis, surgical treatment should be actively carried out to obtain radical resection. For those who cannot be resected, neoadjuvant chemotherapy may lower the stage of tumor and increase the chance of radical surgical resection. The outcome of surgery mainly depends on the location of the tumor and the extent of tumor infiltration into the bile duct, the tumor-free margin of surgery and the presence of lymph node metastasis. The main reasons why long-term survival of surgically treated patients is still unsatisfactory include: about 5% of bile duct cancers are multifocal, 50% of patients have lymph node metastases, and 10% to 20% of patients have peritoneal and distant metastases. In the past, it was believed that liver transplantation could not improve the survival rate of patients with cholangiocarcinoma. Recent studies have shown that preoperative liver transplantation with radiotherapy can significantly improve the long-term survival rate of patients after transplantation. Neoadjuvant radiotherapy can achieve a 5-year tumor-free survival rate of 65% after liver transplantation for cholangiocarcinoma patients. However, the long-term survival rate of patients with tumor diameter >3cm, distant metastasis, transperitoneal tumor puncture biopsy and previous history of malignant tumor is significantly reduced. Preoperative biliary drainage and portal vein embolization Inappropriate preoperative biliary drainage may increase the risk of infection and surgery, and routine preoperative biliary drainage is not recommended. However, preoperative biliary drainage should be performed in patients with malnutrition, cholangitis, or preoperative bilirubin levels >200 μmol/L and extensive hepatectomy is required. Biliary stents should not be placed until the tumor is evaluated for resection. If the patient requires extensive hepatic resection of half or more than half of the liver and the residual liver cannot be compensated, preoperative biliary drainage of the healthy side can be performed to reduce the total bilirubin to 85 μmol/L. After that, portal vein embolization of the diseased liver side can be used to promote the proliferation of the healthy liver tissue, and the safety of surgical resection can be reassessed after 2-3 weeks.