Abstract: Objective To investigate the risk factors of surgical complications of grade ≥Ⅲa and the overall survival rate of hilar cholangiocarcinoma (HC) after resection. Methods The clinical data of 62 patients with HC who underwent surgical resection in the Guangxi Medical University Cancer Hospital from June 2010 to March 2022 were retrospectively analyzed. The risk factors of postoperative complications of grade ≥Ⅲa were analyzed by virtue of logistic regression analysis, and Cox regression model was used to analyze the factors influencing overall survival. Results The incidence of postoperative complications in HC patients was 73.5%(36/49), among which the incidence of ≥Ⅲa complications and the perioperative mortality accounted for 46.9%(23/49) and 10.2%(5/49), respectively. Intraoperative blood loss >500 mL and AJCC stage Ⅲ/Ⅳ were independent risk factors for postoperative complications grade ≥Ⅲa in HC patients (all P<0.05). The median survival of HC patients was 24.0 months, and the 1⁃year, 3⁃year and 5⁃year overall survival rates were 73%, 49% and 20%, respectively. Preoperative CA19⁃9≥150 U/L and total caudate lobed resection were independent factors affecting the overall survival rate (all P<0.05). Conclusions AJCC stage Ⅲ/Ⅳ and intraoperative blood loss >500 mL are risk factors for perioperative complications ≥ grade Ⅲa after HC resection. Preoperative CA19⁃9≥150 U/L is a risk factor for postoperative overall survival, and total caudate lobectomy is a protective factor for postoperative overall survival.

Key words: Hilar cholangiocarcinoma')">Hilar cholangiocarcinoma, Surgical resection, Complication, Overall survival