For the study, the researchers sought to see if combined avascular ablation (VR) in advanced perifoveal cholangiocarcinoma (PHC) was effective and safe. Primary care patients diagnosed between 2001 and 2018 were included in the study. Patients who underwent resection were separated into two groups based on shared virtual reality. Patients undergoing VR were divided into groups based on the type of VR they received. Patient groups were compared in terms of postoperative outcomes and overall survival. Resection was performed on 787 (75%) of 1055 patients (without VR: n = 484, PVR: n = 157, HAR: n = 146). Postoperative complications and mortality were reported at 49% (without VR vs. VR, 48% vs. 50%; s= 0.715) and 2.1% (without VR vs. VR, 1.2% vs. 3.6%; s= 0.040) respectively. Patients who underwent VR resection had a shorter OS (median, 30 months) than those who underwent resection without VR (median, 61 months; s<0.0001), but were longer than those who did not have a resection (median, 10 months; s<0.0001). Difference in OS between those with PVR and those with HAR (median, 29 months vs 34 months; s= 0.517) was not significant. Virtual reality provides a high percentage of patients with locally advanced primary health care that would otherwise be undetectable. It has been indicated whether the thinner hepatic arteries can be repaired, leading to acceptable surgical outcomes and significant improvements in survival.