Background : This study was conducted to evaluate the short-term outcomes after radical surgery with preoperative nab-paclitaxel plus gemcitabine-cisplatin (Gem/Cis/nab-P) triplet chemotherapy in patients with locally advanced perihilar cholangiocarcinoma.

Methods : We retrospectively reviewed patients who underwent radical surgery for locally advanced perihilar cholangiocarcinoma after preoperative chemotherapy with Gem/Cis/nab-P between October 2019 to August 2021 at a single institution.

Results : Twenty-four patients were included in this study. Those patients received mean 5 (4~7) cycle chemotherapy, preoperatively and all patient shows more than partial response. Every patient underwent more than hemihepatectomy with common bile duct resection, including three hepatopancreatoduodenectomy cases. The major postoperative complication rate was 16.7 % and there were two postoperative mortalities (8.3 %). There were two complete remission cases (8.3 %) in the final pathology. R0 resection was achieved in 22 patients (91.6 %). Despite the initial locally advanced cholangiocarcinoma, a pathologic T stage of less than T2 was reported in 23 patients (95.8%) and 15 patients (62.5 %) had no lymph node metastasis. Postoperative the first year overall survival rate was 75% and the first year recurrence rate was 29.1% in this group.

Conclusions : Preoperative Gem/Cis/nab-P chemotherapy with consecutive radical surgery can yield fair first year oncologic outcomes with acceptable postoperative complications to the patients with locally advanced perihilar cholangiocarcinoma