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Hilar cholangiocarcinoma is a highly aggressive malignancy, and surgical resection remains the only potentially curative treatment. Due to the frequent involvement of major vascular structures, vascular resection is increasingly performed to achieve negative surgical margins; however, its impact on survival and postoperative outcomes remains controversial. This retrospective study aims to evaluate the association between vascular resection and clinical outcomes, including survival and postoperative outcomes, in patients with hilar cholangiocarcinoma undergoing curative-intent surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Vascular Resection Group | Patients with hilar cholangiocarcinoma who underwent curative-intent surgery with concomitant vascular resection, including portal vein and/or hepatic artery resection. |
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| Non-Vascular Resection Group | Patients with hilar cholangiocarcinoma who underwent curative-intent surgery without vascular resection. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| No Intervention: Observational Cohort | Other | This is an observational study. No intervention is assigned. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative Complications Grade II or Higher (Clavien-Dindo ≥ II) | Postoperative complications within 30 days after surgery will be assessed and classified according to the Clavien-Dindo classification system. Grade II or higher complications are defined as complications requiring pharmacological treatment, blood transfusion, interventional procedures, reoperation, intensive care management, or resulting in death. | Within 30 days after surgery |
| Overall Survival (OS) | Time from the date of curative-intent surgery to death from any cause or last follow-up. Patients who are alive at the last follow-up will be censored. Survival data will be collected from medical records and follow-up visits. | From surgery to death or last follow-up (up to 5 years) |
| Measure | Description | Time Frame |
|---|---|---|
| Perioperative Mortality | Death occurring within 30 days after surgery or during the index hospitalization, whichever occurs later. | 30 days after surgery or during hospitalization |
| Length of Postoperative Hospital Stay |
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Inclusion Criteria:
Exclusion Criteria:
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The study population includes patients who underwent curative-intent surgery for hilar cholangiocarcinoma at the Department of Hepatobiliary and Pancreatic Surgery of our hospital between January 2010 and December 2024. Patients were included regardless of whether vascular resection was performed. All patients had a pathologically confirmed diagnosis of hilar cholangiocarcinoma and sufficient clinical and follow-up data for outcome analysis. Patients with distant metastasis, those who underwent only palliative or exploratory surgery, or those with incomplete medical records or missing key clinical or follow-up information were excluded. According to intraoperative findings, patients were categorized into vascular resection and non-vascular resection cohorts.
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| ID | Term |
|---|---|
| D018285 | Klatskin Tumor |
| ID | Term |
|---|---|
| D018281 | Cholangiocarcinoma |
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
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Number of days from the date of surgery to hospital discharge.
| From the date of surgery to hospital discharge, assessed up to 90 days. |
| Intraoperative Blood Loss | Estimated blood loss recorded in the operative report, measured in milliliters. | During surgery |
| Disease-Free Survival (DFS) | Time from surgery to tumor recurrence, metastasis, death from any cause, or last follow-up, whichever occurs first. | From surgery to tumor recurrence, metastasis, death, or last follow-up (up to 5 years) |
| D009370 |
| Neoplasms by Histologic Type |
| D009369 | Neoplasms |