Surgical therapy for hilar bile duct cancer

Surgical treatments for hilar bile duct cancerare discussed in relation to the necessity for and most appropriate method of preoperative biliary drainage, desirable operative procedures for achieving long-term survival and the usefulness of portal venous branch embolization before extended hemihepatectomy. We believe that extended right hemihepatectomy can be performed safely after the volume of the remaining liver has been increased by portal embolization and the serum total bilirubin level has dropped to below 2.0 mg/dl. This procedure is a suitable surgical choice for achieving long-term survival in patients with hilar bile duct cancer.