《2025 SAGES-AHPBA指南：胆囊切除术后胆管损伤的外科治疗》由美国胃肠内镜外科医师学会（SAGES）与美洲肝胰胆协会（AHPBA）联合发布，聚焦于胆囊切除术后胆管损伤的确定性修复策略。其采用推荐分级的评估、制订与评价（GRADE）方法学框架，围绕4个关键临床问题展开，包括修复时机、治疗方式、手术方式及吻合技术。各项建议均为“有条件推荐”，证据质量为“极低”，反映了该领域缺乏高质量随机对照研究的现状。指南强调多学科协作、个体化治疗、以病人为中心的理念，并关注资源差异与卫生公平问题。总体上，该指南在整合现有最佳证据与专家经验的基础上，为临床决策提供了结构化、灵活且务实的指导框架。

This article provides a systematic interpretation of the “SAGES-AHPBA 2025 surgical management guidelines for bile duct injury after cholecystectomy”, jointly issued by the Society of American Gastrointestinal and Endoscopic Surgeons and the American Hepato-Pancreato-Biliary Association. The guidelines focus on definitive repair strategies for bile duct injuries following cholecystectomy. Utilizing the GRADE methodological framework, the guidelines address four key clinical questions, including timing of repair, treatment modality, surgical approach and anastomotic technique. All recommendations are “conditional”, supported by evidence of “low” or “very low” quality, reflecting the current lack of high-quality randomized controlled trials in this field. The guidelines emphasize multidisciplinary collaboration, individualized treatment, patient-centered care, and consideration of resource disparities and health equity. Overall, this guideline offers a structured, flexible, and practical decision-making framework based on the best available evidence and expert consensus.