Major Hepatic Resection for Hilar Cholangiocarcinoma without Preoperative Biliary Drainage

Hilar cholangiocarcinoma is a rare cancer in western countries but very high incidence in the northeast ofThailand. The only chance to cure is surgical resection. Preoperative biliary drainage (PBD) for improving liverfunction to decrease perioperative morbidity and mortality is claimed to be beneficial. To determine whetherliver resection with hilar resection is a safe procedure in obstructive jaundice patients caused by hilarcholangiocarcinoma, the records of 30 consecutive patients undergoing surgery between May 1999 and May2002 at Srinagarind hospital, Khon Kaen University, were retrospectively analyzed. Two patients died duringhospitalization, an operative mortality of 6.7%. Survival was 33% at 1 year, 12% at 2 years,10% at 3 years and6.7% at 4 years. In our experience, it is safe in most patients with obstructive jaundice due to hilarcholangiocarcinoma to perform liver resection without preoperative biliary drainage (PBD).