Management of Preoperative Cholangitis Improves the Hepatic Failure after Hepatectomy for Hilar Cholangiocarcinoma

Abstract

Hilar cholangiocarcinoma with obstructive jaundice is an indication to be performed major hepatectomy as a curative treatment. However, hepatic failure in most of major hepatectomized patients still remains to a serious problem and causes of poor prognosis. We investigated the factors of hepatic failure in 28 hepatectomized patients for hilar cholangiocarcinoma. The higher rate of hepatectomy and poor management of preoperative cholangitis signigicantly correlated to postoperative liver failure (p=0.01 and p<0.001, respectively.) Moreover, preoperative cholangitis is significantly correlated to hospital death (p=0.01). Therefore, percutaneous transhepatic biliary drainage (PTBD) for management of preoperative cholangitis improves postoperative morbidity and postoperative hepatic failure. PTBD should be performed for not only reduction of jaundice but also management of preoperative cholangitis.