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Updated: Sep 13, 2025
Laparoscopic Anatomical Liver Segment VII Resection with Liver Parenchymal Transection Following a Priority Approach
Published on: May 23, 2025
Surgical complexity and long-term outcomes after liver resection for intrahepatic cholangiocarcinoma: a multicenter
Tomoaki Yoh1, Shinichi Nakanuma2, Makoto Kurimoto1
1Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Introduction:
Intrahepatic cholangiocarcinoma (ICC) can invade surrounding structures such as inferior vena cava or hepatic hilum, leading to the surgical complexity; however, its effect on long-term outcomes remains poorly understood.
Methods:
Data from consecutive patients with ICC who underwent liver resection (LR) between 2000 and 2020 at three tertiary hepatobiliary centers were retrospectively analyzed. Surgical complexity was defined as follows: Class I; LR, Class II; LR with biliary resection and reconstruction only, and Class III; LR with major vascular resection and reconstruction.
Results:
A total of 303 patients were enrolled in this study, with 206 (68.0 %), 64 (21.1 %), and 33 (10.9 %) classified as Class I, Class II, and Class III, respectively. The median overall survival (OS) for Class I, Class II, and Class III was 57.6 months, 31.0 months, and 17.5 months, respectively (P < 0.001). On multivariate analysis, Class III was identified as an independent predictor of poorer OS together with lymph node metastasis and tumor multiplicity; Class I and Class II were not independent.
Conclusion:
Surgical complexity may help stratify survival outcomes in patients with ICC after LR. Moreover, the poor prognosis associated with Class III highlights the requirement of a refined strategy for these patients.
