Individualization of treatment for hilar bile duct cancers

Two cases of hilar bile duct cancer are presented, 1 treated with the preferred technique of left intrahepatic anastomosis, the other with tube drainage. The many factors to be considered before choosing the most appropriate procedure are stressed. A critique of several techniques is offered, with a discussion of the nuances in decision making. The surgeon who embarks upon treatment of such tumors should be thoroughly familiar with the wide range of procedures available; better selection should improve palliation.