Vascular Resection in Perihilar Cholangiocarcinoma: How Much Is Two Much

Introduction: Surgery for perihilar cholangiocarcinoma is demanding. Frequently, vascular invasion occurs. Vascular resection correlates with worse perioperative outcomes. The authors aim to discuss the limits of resection. Methods: A prospective database ranging from October 2004 May 2021 was analyzed. Relevant clinical-pathological variables correlating outcomes and survival were collected correlated types Results: 219 patients submitted surgery curative intent cholangiocarcinoma. Median age 67 (11-85) 40 (18.3%) classified as Bismuth type 4. ERCP percutaneous biliary drainage similarly used decompression. In total, 189 (86.3%) combined liver 78 portal vein 8 arterial (5 resection). 2 associated vena cava procedure. R0 rate 57.5% mortality 11.4% (decreasing below 5% since 2014). Mortality 25% (one 11.5%. 5-year 30%, 25%. Age previous cholangitis mortality. Conclusion: Although may impact outcomes, long-term justifies its use in referral centers. Older should weight decision proceed