Evidence map›Paper›PMID 40946124›Full record

ArticleAnnals of surgical oncology2025

Operative and Oncological Outcomes of Vascular Resection and Reconstruction for Perihilar Cholangiocarcinoma.

Edoardo Poletto, Pim B Olthof, Frederik J H Hoogwater, Joris I Erdmann, Andreas A Schnitzbauer, Ernesto Sparrelid, Shishir K Maithel, Cristina Dopazo, Abdul R Hakeem, Francesca Ratti and 3 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Outcomes of Liver Transplant Versus Partial Hepatectomy for Perihilar Cholangiocarcinoma Patients Requiring Arterial Reconstruction.Liver international : official journal of the International Association for the Study of the Liver · 2026
    Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Edoardo PolettoDivision of General and Hepato-Biliary Surgery, Department of Surgery, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy.
Pim B OlthofDivision of Hepato-Pancreato-Biliary Surgery and Transplantation, Department of Surgery, Erasmus MC Cancer Institute, Erasmus University, Rotterdam, The Netherlands.
Frederik J H HoogwaterDepartment of Surgery, Division of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Joris I ErdmannDepartment of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Andreas A SchnitzbauerKlinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Frankfurt, Frankfurt, Germany.
Ernesto SparrelidDivision of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Shishir K MaithelDivision of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Cristina DopazoDepartment of HBP Surgery and Transplants, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Universitat Autónoma de Barcelona, Barcelona, Spain.
Abdul R HakeemDivision of Surgery, Department of Hepatobiliary and Liver Transplant Surgery, St James's University Hospital, Leeds, UK.
Francesca RattiHepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy.
Andrea Ruzzenente *Division of General and Hepato-Biliary Surgery, Department of Surgery, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy.
Bas Groot Koerkamp *Division of Hepato-Pancreato-Biliary Surgery and Transplantation, Department of Surgery, Erasmus MC Cancer Institute, Erasmus University, Rotterdam, The Netherlands. b.grootkoerkamp@erasmusmc.nl.
Perihilar Cholangiocarcinoma Collaboration Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHepatectomy with associated vascular resection and reconstruction (VR) is an option to increase the number of patients with locally advanced perihilar cholangiocarcinoma (pCCA) eligible for radical-intent surgery.

objectivesThis study aimed to assess the safety and oncological outcomes of VR in pCCA patients.

methodsPatients who underwent surgery for pCCA at 10 western centers were retrospectively reviewed and divided according to the performance of the VR. Primary outcomes were major morbidity, vascular morbidity, 90-day mortality, and overall survival (OS).

resultsA total of 1054 patients were included, of whom 259 (24.6%) underwent VR. Of these 259 patients, 199 (76.8 %) underwent portal vein reconstruction (PVR) only and 60 (23.2%) underwent hepatic artery reconstruction (HAR) with or without PVR. VR patients were younger (66 vs. 68 years; p = 0.011) and more frequently had Bismuth type 4 tumors (31.3% vs. 22.9%; p = 0.008). They more frequently underwent portal vein embolization (32.0% vs. 17.6%; p < 0.001), biliary drainage (84.9% vs. 77.3%; p = 0.008), and extended hepatectomy (56.8% vs. 37.1%; p < 0.001), with longer operative times (539 vs. 479 min; p < 0.001) and higher blood loss (1300 vs. 700 mL; p < 0.001). Positive resection margins were observed more frequently (45.7% vs. 35.2%; p = 0.003). Major complications (51.4% vs. 41.0%; p = 0.004), vascular complications (19.7% vs. 3.3%; p < 0.001), and mortality (16.2% vs. 10.6%; p = 0.02) were higher in VR patients. Median OS was 28.0 months for patients without VR versus 22.8 months for patients with VR (p = 0.18).

conclusionsLiver resection and VR in patients with locally advanced pCCA are associated with increased major and vascular morbidity but offer similar survival as patients not undergoing VR; therefore, VR should be considered in selected patients.

Indexed as

Bile Duct NeoplasmsHepatectomyHepatic ArteryKlatskin TumorPortal VeinPostoperative ComplicationsVascular Surgical ProceduresAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateBiliary tract cancerOncological outcomesPerihilar cholangiocarcinomaVascular reconstructionVascular resection

Identifiers

PMID40946124
PMCPMC12589212

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.