Vascular resection in distal cholangiocarcinoma: Review of the literature

Vascular resection including portal vein resection and/or hepatic artery resection has rarely been reported in distal cholangiocarcinoma. This review aimed to elucidate the safety and oncological outcomes of surgery with vascular resection in patients with distal cholangiocarcinoma. The following data were extracted from the identified studies: type of vascular resection, surgical outcome, pathological findings, recurrence-free survival (RFS), and overall survival (OS). Six studies were identified, and patients were classified into the vascular resection (VR) group and non-VR group according to the presence or absence of vascular resection in each study. The vascular resection ratios ranged from 6.8% to 20.0% in the surgical cases. The most frequent tumor location in the VR group was the extrapancreatic common bile duct and the most frequent sites of vascular resection were portal vein and right hepatic artery. The ratios of T3 or T4 tumor were significantly higher in the VR group. The ratios of severe complications and postoperative mortality were not significantly different between the VR and non-VR groups. The median RFS time and OS time in the VR group were shorter than 1 year and 2 years, respectively, in all studies. In conclusion, the patients with distal cholangiocarcinoma in the VR group tended to show early recurrence and shorter survival, although vascular resection could be performed safely.