ArticleJournal of the American College of Surgeons2016
Postoperative Mortality after Liver Resection for Perihilar Cholangiocarcinoma: Development of a Risk Score and Importance of Biliary Drainage of the Future Liver Remnant.
Article in Journal of the American College of Surgeons, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07558304 (Randomized Clinical Trial of Suprapapillary Drainage With Metal Stent vs. Routine Internal-External Transpapillary Drainage in Patients With Malignant Hilar Biliary Obstruction), which is not on this map. Cited by 87 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Randomized Clinical Trial of Suprapapillary Drainage With Metal Stent vs. Routine Internal-External Transpapillary Drainage in Patients With Malignant Hilar Biliary Obstruction
Who cites it
87 citing papers in PubMed, 4 syntheses or guidelines pooled it, 214 citations in OpenAlex.
- Textbook outcome after major hepatectomy for perihilar cholangiocarcinoma - definitions and influencing factors.Langenbeck's archives of surgery · 2022Pooled it
- Left-side vs. right-side hepatectomy for hilar cholangiocarcinoma: a meta-analysis.World journal of surgical oncology · 2021Pooled it
- The effect and safety of preoperative biliary drainage in patients with hilar cholangiocarcinoma: an updated meta-analysis.World journal of surgical oncology · 2020Pooled it
- Pooled it
- Survival prediction for patients with malignant biliary obstruction caused by pancreatic cancer undergoing biliary drainage: the COMBO-PaS model.Surgical endoscopy · 2023Trial
- The Role of Gut Microbiota in Liver Regeneration After Partial Hepatectomy: New Evidence From Animal and Human Studies.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2026Review
- Association of bilirubin reduction rate after percutaneous transhepatic cholangiographic drainage with major complications in hilar cholangiocarcinoma.BMC gastroenterology · 2026Article
- Sarcopenia does not affect total liver function measured using technetium-99m mebrofenin hepatobiliary scintigraphy.EJNMMI research · 2026Article
- Survival benefit of surgical resection in elderly patients with extrahepatic cholangiocarcinoma: a propensity score-matched analysis.Langenbeck's archives of surgery · 2026Article
- Perioperative approaches for patients with biliary tract cancer.Nature reviews. Clinical oncology · 2026Review
- Role of Endoscopy in Malignant Biliary Obstruction.Diagnostics (Basel, Switzerland) · 2026Review
- Cholangiocarcinoma: Is Preoperative Histologic Confirmation Mandatory Before Major Hepatobiliary Surgery?Cureus · 2026Review
- Value of albumin-bilirubin grade for 90-day mortality and long-term outcomes in patients with perihilar cholangiocarcinoma: a multicenter retrospective cohort study.Therapeutic advances in medical oncology · 2026Article
- Textbook Outcome After Major Liver Resection for Primary and Secondary Liver Tumors at Specialized German Hepatobiliary Centers: Analysis of the StuDoQ Liver Registry.Annals of surgical oncology · 2025Article
- Improved Outcomes Following Resection of Perihilar Cholangiocarcinoma: A 27-Year Experience.Annals of surgical oncology · 2025Article
- Intraoperative blood loss in perihilar cholangiocarcinoma: should we aim below a certain cut-off?Hepatobiliary surgery and nutrition · 2025Article
- Failure to Rescue After Resection of Perhilar Cholangiocarcinoma in an International Multicenter Cohort.Annals of surgical oncology · 2025Article
- Comparing Survival of Perihilar Cholangiocarcinoma After R1 Resection Versus Palliative Chemotherapy for Unresected Localized Disease.Annals of surgical oncology · 2024Article
- Risk model for morbidity and mortality following liver surgery based on a national Japanese database.Annals of gastroenterological surgery · 2024Article
- Higher Postoperative Mortality and Inferior Survival After Right-Sided Liver Resection for Perihilar Cholangiocarcinoma: Left-Sided Resection is Preferred When Possible.Annals of surgical oncology · 2024Article
27 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundLiver surgery for perihilar cholangiocarcinoma (PHC) is associated with postoperative mortality ranging from 5% to 18%. The aim of this study was to develop a preoperative risk score for postoperative mortality after liver resection for PHC, and to assess the effect of biliary drainage of the future liver remnant (FLR). STUDY
designA consecutive series of 287 patients submitted to major liver resection for presumed PHC between 1997 and 2014 at 2 Western centers was analyzed; 228 patients (79%) underwent preoperative drainage for jaundice. Future liver remnant volumes were calculated with CT volumetry and completeness of FLR drainage was assessed on imaging. Logistic regression was used to develop a mortality risk score.
resultsPostoperative mortality at 90 days was 14% and was independently predicted by age (odds ratio [OR] per 10 years = 2.1), preoperative cholangitis (OR = 4.1), FLR volume <30% (OR = 2.9), portal vein reconstruction (OR = 2.3), and incomplete FLR drainage in patients with FLR volume <50% (OR = 2.8). The risk score showed good discrimination (area under the curve = 0.75 after bootstrap validation) and ranking patients in tertiles identified 3 (ie low, intermediate, and high) risk subgroups with predicted mortalities of 2%, 11%, and 37%. No postoperative mortality was observed in 33 undrained patients with FLR volumes >50%, including 10 jaundiced patients (median bilirubin level 11 mg/dL).
conclusionsThe mortality risk score for patients with resectable PHC can be used for patient counseling and identification of modifiable risk factors, which include FLR volume, FLR drainage status, and preoperative cholangitis. We found no evidence to support preoperative biliary drainage in patients with an FLR volume >50%.
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