Surgical management of hilar cholangiocarcinoma

Purpose of Review To provide a comprehensive review of the preoperative and operative considerations for the surgical management of hilar cholangiocarcinoma. Recent Findings The management of hilar cholangiocar-cinoma has evolved over the past 20 years, with data from large institutional series emerging, which has influenced decisions regarding the need for preoperative biliary drai-nage, portal-vein embolization, extent of surgical resection, role of transplantation, and efficacy of adjuvant and palliative therapies. Summary Hepatectomy has become the standard of care for resectable hilar cholangiocarcinoma, while transplantation can offer promising results for unresectable patients with localized disease. Perioperative mortality can be minimized through careful preoperative management of the future liver remnant via appropriate use of biliary drainage and portal-vein embolization. Adjuvant therapies prolong survival after resection, while emerging data on endolu-minal therapies and radiation provide palliation and improved survival for patients with advanced, unresectable disease. © Springer Science+Business Media, LLC, part of Springer Nature 2018.