Introduction
Extreme liver and bile duct surgery including extended and staged resections, vascular and biliary reconstructions, ex vivo techniques, and transplant oncology has evolved rapidly without an internationally agreed standard. The underlying evidence derives largely from smaller, heterogeneous series at major risk of bias; robust randomized trials are rare. This field shows substantial practice variation and opposing expert opinions.
A consensus conference with methodology of the Zurich–Danish Model is the logical next step to move further with this field. It combines exhaustive literature review, expert opinion, public debate, and impartial arbitration by an independent jury. The conference will be hosted in Beijing at Tsinghua University HPB Hospital / Beijing Tsinghua Changgung Hospital from October 7–9, 2027.
The core principle is a strict separation between those who provide the evidence (the expert panels) and those who formulate the final recommendations (the independent, non-specialist jury). This design minimizes bias and produces broadly accepted, evidence-based recommendations.
The plan covers a consensus definition of the field, governance and committees, a scientific scope with nine panels and fully worded consensus questions, the three-phase process, a timeline with milestones, a funding and publication concept, the coordination in the organization between Zurich and Beijing, a proposed Zoom agenda, and some suggested international faculty members.
Through this collaborative process, we can establish a clearer framework for extreme liver and bile duct surgery—one that helps surgeons make better decisions, defines appropriate boundaries for intervention, and ultimately improves outcomes for patients facing the most complex hepatobiliary diseases.
Welcome Letter
Distinguished Colleagues and Friends,
It is our great pleasure to extend our warmest welcome to all participants of the International Consensus Conference on Extreme Liver and Bile Duct Surgery, to be held in Beijing, China, from October 7–9, 2027.
We are delighted to bring together surgeons, clinicians, researchers, and experts from diverse disciplines, institutions, and backgrounds who share a common commitment to advancing the field of hepatobiliary surgery. It is our belief that meaningful progress in addressing the most challenging questions in modern surgery requires not only scientific excellence and technical innovation, but also open dialogue, international collaboration, and a shared commitment to improving patient outcomes.
The concept of precision surgery emphasizes achieving an optimal balance between complete treatment of disease, preservation of functional organ reserve, and management of operative risks especially as surgery approaches the limits of conventional resectability. As surgical techniques continue to advance, our challenge is not merely to expand what is technically possible, but also to define appropriate indications, acceptable risks, meaningful outcomes, and the ethical boundaries of surgical intervention. Against this background, the conference aims to address some of the most difficult and unresolved questions in modern hepatobiliary surgery.
Through rigorous scientific discussion, critical evaluation of available evidence, and the exchange of clinical experience, we hope to foster a deeper understanding of these complex challenges and contribute to the development of practical, evidence-informed consensus recommendations for surgeons and multidisciplinary teams worldwide.
Above all, we envision this conference as a platform for lasting international collaboration, one that inspires new ideas, bridges different perspectives, and strengthens our collective commitment to advancing safe, responsible, and patient-centered surgical care.
We look forward to seeing you in Beijing in for what promises to be an engaging and rewarding scientific exchange.
With warm regards,
Conference Co-Chairs
Jiahong Dong & Pierre-Alain Clavien
International Consensus Conference on Extreme Liver and Bile Duct Surgery