Hilar cholangiocarcinoma: surgical and endoscopic approaches

Cholangiocarcinoma remains an uncommon malignancy in the United States and is associated with a grim prognosis. Developments in preoperative imaging have optimized surgical evaluation and treatment decision making. Increased use of extended resections (primarily hepatic resections) has led to prolonged survival in a increasing fraction of patients who undergo operative exploration. Finally, palliation remains a significant goal in patients who harbor unresectable disease; percutaneous and endoscopic methods are the mainstay of palliative therapeutic interventions.