本研究旨在调查肝门周围胆管癌（pCCA）切除肝缘（LM）癌的患病率和分布情况，并建立LM检查方法。LM是切除pCCA中最大的边缘，其状态和评估方法尚不明确。227 pCCA接受主要肝切除术的病例被分为使用连续整体数字大切片 (WDLS) 结合小切片进行评估的发现队列 (n=101) 和仅使用小切片进行评估的对照队列 (n=126)。LM R1发现组的切除率为 38.6% (39/101)，对照组为 5.6% (7/126)。与发现队列中的小部分相比，WDLS 发现了更多的 LM R1 病例（38.6% vs. 5.9%，P<0.001）。发现队列中的 R0 患者的总生存期和无复发生存期均优于对照组（均 P<0.05）。此外，95% 的癌症发现于近端导管边缘 (DM) 20 毫米内。近端 DM 距离 <5 mm 是 LM R1 切除的独立危险因素。与 ≥ 5 mm 的患者相比，这些患者更有可能经历 R1 (P<0.001)。LM 阳性是 pCCA R1 切除的重要原因，WDLS 的使用提高了 LM 的诊断准确性。建立了一种检查方法，强调了在近端 DM 周围 20 毫米半径范围内检查 LM 的必要性，特别是对于近端 DM <5 毫米的患者。版权所有 © 2024 Wolters Kluwer Health, Inc. 保留所有权利。

This study aimed to investigate the prevalence and distribution of carcinoma in the liver margin (LM) of resected perihilar cholangiocarcinoma (pCCA) and establish a method for LM examination.LM is the largest margin in resected pCCA with undefined status and assessment method.227 pCCA cases underwent major hepatectomy were divided into a discovery cohort (n=101) assessed using serial whole-mount digital large sections (WDLS) combined with small sections, and a control cohort (n=126) assessed using only small sections.The LM R1 resection rate was 38.6% (39/101) in the discovery cohort and 5.6% (7/126) in the control cohort. WDLS identified more LM R1 cases compared to the small section in the discovery cohort (38.6% vs. 5.9%, P<0.001). R0 patients in the discovery cohort had better overall survival and recurrence-free survival than those in the control cohort (both P<0.05). Additionally, 95% of carcinoma was found within 20 mm of the proximal ductal margin (DM). A proximal DM distance of<5 mm was an independent risk factor for LM R1 resection. Patients with which are more likely to experience R1 compared to those with ≥ 5 mm (P<0.001).Positive LM was the significant cause for R1 resection of pCCA and the utilization of WDLS improved the diagnostic accuracy of LM. An examination methodology was established, highlighting the necessity of examining LM within a 20 mm radius around the proximal DM, especially in patients with a proximal DM of<5 mm.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.