Systematic Review and Meta-analysis of Surgery for Hilar Cholangiocarcinoma With Arterial Resection 

Abstract Objective: With the advances in multimodality treatment in the recent years, an analysis of the outcome of vascular resections in surgery of hilar cholangiocarcinoma is lacking. The aim of this meta-analysis was to summarize the currently available evidence on outcomes of patients undergoing arterial resection for the treatment of hilar cholangiocarcinoma. Methods: A systematic literature search from PubMed/Medline, Cochrane Library, Cinahl, ClinicalTrials.gov (clinical trials registry) and WHO ICTRP (clinical trials registry,) databases will be carried out. PRISMA guidelines will be followed. Pre-defined outcomes are mortality (100-day and in-hospital), morbidity (Clavien-Dindo classification, any type of complication, surgical and medical), vascular complications (thrombosis of the portal vein or hepatic artery, stenosis of these vessels, and pseudoaneurysms), liver failure, postoperative bleeding, duration of surgery, reoperation rate, length of hospital stay, survival time, actuarial survival (2-, 3- and 5-year survival), R0/R1/R2 resection rates, proportion of patients with no resection during surgery, rate of histologic arterial invasion and lymph node positivity (number of positive lymph nodes and lymph node ratio). Discussion: Our findings will enable us to present the current evidence on feasibility, safety and oncological effectiveness of surgery for hilar cholangiocarcinoma with arterial resection. These data will support healthcare professionals in their clinical decision-making.Systematic review registration: PROSPERO ID 223396