Abstract
Recent reviews of the management of hilar biliary cancer suggest that radical resection is the preferred treatment option. It seems true that most of the long term survivors are treated this way, but it is equally true that most patients receive palliative rather than curative treatment. Before we go too far in our advocacy of radical treatment, we need to develop methods for quantifying palliation because that is in truth what we usually achieve. A method of quantifying palliation is described. Surgeons are encouraged to use methods of this kind in order to allow valid comparison of the results of different methods of treatment.