Curative resection of borderline resectable perihilar cholangiocarcinoma following neoadjuvant gemcitabine and cisplatin plus durvalumab immunochemotherapy: a case report.

Postoperative survival benefits of neoadjuvant gemcitabine and cisplatin plus durvalumab (GCD) immunochemotherapy for biliary tract cancers, which meet the criteria for borderline resectability, remain limited. A 75-year-old male presented to our hospital with epigastric pain. Diagnostic imaging demonstrated perihilar cholangiocarcinoma invading the right hepatic artery with lymph node metastasis. The patient was diagnosed with borderline resectable perihilar cholangiocarcinoma (cT3N1M0 Stage IIIC) and treated with seven cycles of GCD immunochemotherapy. Dynamic computed tomography post-immunochemotherapy revealed that the tumor decreased in size, and arterial invasion and swollen lymph nodes had disappeared. At 6 months following immunochemotherapy initiation, the patient underwent left hepatectomy, lymph node dissection, and biliary reconstruction. Histopathology showed inflammatory cell infiltration in the bile duct mucosa without cancer cells. No lymph node metastases were detected. At 2 years postoperatively, the patient remains stable without recurrence.