Major hepatectomy with concomitant vascular resection (portal vein and/or hepatic artery) for perihilar cholangiocarcinoma

Background: Back ground: Concomitant major vascular resection was required to achieve curative (R0) resection in perihilar cholangiocarcinoma, however, it is also difficult to go together R0 resection and surgical safety. Purpose: To evaluate short and long term surgical results for perihilar cholangiocarcinoma who performed concomitant vascular resection. Methods: Patients: From January 2000 to December 2015, we performed 200 major hepatectomy for perihilar cholangiocarcinoma patients. Among these patients 104 patients were performed concomitant vascular resection. These 104 patients were evaluated. Results: There were 76 of men. Median age was 68 year (46–80). There were 58 of right hepatectomy, 33 of left hepatectomy, 3 of right trisectionectomy, and 6 of left trisectionectomy. There were 78 of portal vein resection, 4 of hepatic artery resection, and 22 of both portal vein and hepatic artery. Operation time was 686min (325-1250). Operative bleeding was 1845ml (510-27860). Morbidity (Clavien Dindo IIIA≧) was 51％ (3.8% patients had vascular related complications), and mortality (in hospital death) was 7.7%. We achieved 79% R0 resection, and 5-year survival rate was 40%. Conclusion: Conclusion: Our surgical results of concomitant vascular resection for perihilar cholangiocarcinoma were thought to be acceptable, however, new strategy for decreasing morbidity and mortality is required.