{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T10:34:28Z","timestamp":1791974068148,"version":"4.4.0"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T00:00:00Z","timestamp":1782000000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T00:00:00Z","timestamp":1782000000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Liver resection (LR) and orthotopic liver transplantation (OLT) are therapeutic options for locally advanced perihilar cholangiocarcinoma (pCCA) requiring hepatic artery reconstruction (HAR). This study aimed to compare short\u2010 and long\u2010term outcomes of LR and OLT. Outcomes were major vascular complications, 90\u2010day mortality, overall survival (OS) and recurrence\u2010free survival (RFS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cohort of patients undergoing LR with HAR from 10 Western centres was compared with an OLT cohort comprising patients who received or did not receive neoadjuvant chemoradiotherapy (NACR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      109 patients, 60 LR and 49 OLT (22 OLT no\u2010NACR and 27 OLT NACR) were included. LR patients were older and had fewer Bismuth type 4 tumours (38.3% vs. 69.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). Positive margins (49.2% vs. 6.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and lymph nodes (54.2% vs. 32.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.058) were found more frequently in LR patients. No differences were found between LR and OLT in major (40% vs. 46.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.56) and vascular complications (23.3% vs. 28.6%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.66); NACR was an independent prognostic factor for vascular complications (OR 2.63, 95% CI 1.03\u20136.70,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043). 90\u2010day mortality (15% for LR vs. 10.2% for OLT,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.57) and 5\u2010year OS (HR 0.68, 95% CI 0.40\u20131.17,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.17) were similar. Median OS after LR versus OLT was higher but not significant (24 vs. 40\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.13). OLT had better 5\u2010year RFS (HR 0.52, 95% CI 0.29\u20130.96,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035) than LR. R1 resection (HR 2.07, 95% CI 1.03\u20134.18,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041) and perineural invasion (HR 3.64, 95% CI 1.09\u201312.16,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035) were independent prognostic factors for RFS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LR and OLT for locally advanced pCCA had similar rates of major complications and post\u2010operative mortality, but NACR was associated with increased vascular complications. Survival was difficult to compare in the groups due to their heterogeneity, but OLT, especially with NACR, seems to give better results than LR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70729","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T05:01:37Z","timestamp":1782104497000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes of Liver Transplant Versus Partial Hepatectomy for Perihilar Cholangiocarcinoma Patients Requiring Arterial Reconstruction"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9222-0104","authenticated-orcid":false,"given":"Edoardo","family":"Poletto","sequence":"first","affiliation":[{"name":"Department of Surgery, Dentistry, Gynaecology and Paediatrics, Division of General and Hepato\u2010Biliary Surgery University of Verona  Verona Italy"},{"name":"Department of Surgery, Division of Hepato\u2010Pancreato\u2010Biliary and Transplant Surgery Erasmus MC Transplant Institute University Medical Center Rotterdam  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim B.","family":"Olthof","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Hepato\u2010Pancreato\u2010Biliary and Transplant Surgery Erasmus MC Transplant Institute University Medical Center Rotterdam  Groningen the Netherlands"},{"name":"Department of Surgery, Division of Hepato\u2010Pancreato\u2010Biliary Surgery and Liver Transplantation University of Groningen, University Medical Center Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Ruzzenente","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dentistry, Gynaecology and Paediatrics, Division of General and Hepato\u2010Biliary Surgery University of Verona  Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Philippe","family":"Adam","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery and Transplantation University Hopital Bordeaux  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0603-9849","authenticated-orcid":false,"given":"Ian P. J.","family":"Alwayn","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Transplantation Surgery, LUMC Transplant Center Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Boleslawski","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery and Transplantation, CHU Lille University of Lille  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke T.","family":"de Boer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Hepato\u2010Pancreato\u2010Biliary Surgery and Liver Transplantation University of Groningen, University Medical Center Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Chebaro","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery and Transplantation, CHU Lille 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Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris I.","family":"Erdmann","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cancer Center Amsterdam Amsterdam UMC, University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Hakeem","sequence":"additional","affiliation":[{"name":"Division of Surgery, Department of Hepatobiliary and Liver Transplant Surgery St James's University Hospital  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3434-4421","authenticated-orcid":false,"given":"Minneke J.","family":"Coenraad","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, LUMC Transplant Center Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrien","family":"Kuipers","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Hepato\u2010Pancreato\u2010Biliary Surgery and Liver Transplantation University of Groningen, University Medical Center Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Yves","family":"Mabrut","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery and Liver Transplantation H\u00f4pital De La Croix Rousse  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0384-6592","authenticated-orcid":false,"given":"Charlotte","family":"Maulat","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery and Liver Transplantation Toulouse\u2010Rangueil University Hospital  Toulouse 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Darwish","family":"Murad","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Erasmus MC Transplant Institute University Medical Center Rotterdam  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrice","family":"Muscari","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery and Liver Transplantation Toulouse\u2010Rangueil University Hospital  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Rolinger","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplant Surgery University HospitalT\u00fcbingen  T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3096-4893","authenticated-orcid":false,"given":"Wojciech G.","family":"Polak","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of 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