For a study, the researchers sought to see if combined vascular resection (VR) in advanced perihilar cholangiocarcinoma (PHC) was effective and safe. PHC patients diagnosed between 2001 and 2018 were included in the study. The patients who underwent resection were separated into 2 groups based on their combined VR. Patients undergoing VR were divided into groups based on the type of VR they received. The patient groups were compared in terms of postoperative outcomes and overall survival. Resection was performed on 787 (75%) of the 1055 patients (without VR: n=484, PVR: n=157, HAR: n=146). Postoperative complications and mortality were reported to be 49% (without VR vs with VR, 48% vs 50%; P=0.715) and 2.1% (without VR vs with VR, 1.2% vs 3.6%; P=0.040), respectively. Patients who had resection with VR had a shorter OS (median, 30 months) than those who had resection without VR (median, 61 months; P<0.0001), but it was longer than those who did not have resection (median, 10 months; P<0.0001). The difference in OS between those who had PVR and those who had HAR (median, 29 months vs 34 months; P=0.517) was not significant. VR saves a high percentage of patients with locally progressed PHC that would otherwise be unresectable. It was indicated if the hilar hepatic inflow arteries could be repaired, resulting in acceptable surgical outcomes and significant survival improvements.