Introduction : Radical resection is the only curative treatment for patients with hilar cholangiocarcinoma. This study aimed to compare the surgical morbidity and long-term outcome between right- and left-side hepatectomy to help the decision of which side of liver to be resected in the surgical treatment of hilar cholangiocarcinoma.

Methods : A total of 83 patients attempting surgical resection for hilar cholangiocarcinoma at the Korea university medical center between 2010 and 2017 were considered for this study. After excluding patients who did not undergo curative-intent surgery or hepatectomy, 57 patients undergoing right- or left-side hepatectomy were finally enrolled for analysis. Prospectively collected clinicopathologic characteristics, perioperative outcomes and survival were evaluated.

Results : Right-side hepatectomy (RH) and left-side hepatectomy (LH) were performed for 33 and 24 patients, respectively. The proportion of R0 resection was comparable between both groups (66.7% for both RH and LH groups, p=0.616). Posthepatectomy liver failure was significantly more prevalent in the RH group than LH group (75.7% vs. 12.5%, p<0.001). The 90-day mortality was not differ between both groups (9.1% vs. 4.2%, p=0.631). The 5-year overall survival rates were 37.7% for the RH group; and 41.9% for the LH group (p=0.500). The 5-year recurrence-free survival rates were 26.3% for the RH group; and 33.9% for the LH group (p=0.580).

Conclusions : Posthepatectomy liver failure was more prevalent in the RH group than LH group, but it did not affect the 90-day mortality. It is recommended to perform surgical resection only according to the possibility to achieve radical resection, regardless of right- or left-side hepatectomy.