The significance of vascular resection and reconstruction in patients with locally advaned peihilar cholangiocarcinoma

Abstract

This study aimed to elucidate the significance of combined vascular resection and reconstruction (VR) in surgery for locally advanced perihilar cholangiocarcinoma (PHC). Eighty-one resected PHC patients were divided into three groups: non-VR (n=37), VR of portal vein (VR-PV: n=25), and VR of hepatic artery (VR-HA: n=12) Preoperative CA19-9 levels of both VR-PV and VR-HA groups were significantly high compared to those of non-VR group. There were no significant differences in rates of morbidity and mortality among three groups. In pathological findings, although both VR-PV and VR-HA groups had a significantly higher rate of advanced tumor (≥T3) compared to non-VR group, there were no significant differences in rates of lymph node metastasis and R0 resection among three groups.

Although 5-year disease specific survival (5-year DDS) in VR-PV (29%) and VR-HA (25%) groups were tended to be poor compared to patients in non-VR group (42%), they were significantly better as compared to that in patients with unresected locally advanced PHC (5%). It was considered that VR in surgery for locally advanced PHC was feasible and useful.