Palliation of Extra-Hepatic Biliary Malignancies: Diminishing Role for Surgery

In a recently published manuscript, Buettner and colleagues [1] provides an analysis of outcomes following palliative surgery for extra hepatic biliary malignancies over a period of 15 years from ten of the best cancer centres in the United States. Their findings suggest that palliative bypass surgery is associated with increased morbidity and no survival benefit compared with ‘open and close’ laparotomies. It has been shown that palliative bypass surgery is not associated with a reduction in the number of invasive procedures or to overall hospital stay [2].