Modified long Mire Technique for Biliary Decompression in Hilar Cholangiocarcinoma (Klatskin Tumor) Over 10 Years Experience of a Single Center

Background: Patients with malignant obstruction of the biliary tract suffer from progressive jaundice and purities, and if the obstruction is not relieved they will die from cholangitis, septicaemia or liver failure. The correct choice between many operative and non-operative procedures available to relive jaundice is not yet determined. Unresectable disease (perihilar cholangiocarcinoma) found at the time of open exploration can be treated with a palliative surgical biliary bypass such as modified Longmire technique. Methods: Eighteen (18) cases with unresectable hilar cholangiocarcinoma found at the operation underwent modified Longmire technique for biliary decompression. Results: The mean preoperative bilirubin level was 22 mg/dl. The post operative mean total bilirubin level was below 5mg/dL about 1 month after surgery. During the follow-up period, averaging 22 months (max 6 years), jaundice recurred only near the death of these patients. There was 1 in-hospital death, and the median survival was 18 months (maximum 6 years). The operation completely relieved the jaundice, and excellent palliation was achieved for more than 85% of the survival time. Conclusion: We found this technique very effective to palliate patients mentioned above.