Figure 1.

Decision criteria for the strategy for preoperative management of major hepatectomy in biliary cancer. Preoperative biliary decompression is performed to reduce the serum bilirubin concentration to below 2 mg/dL. When the value of the indocyanine green retention rate at 15 min (ICG R15) after relief of jaundice meets the requirements, limited PE is performed. At 2 weeks after PVE, patients with ICG R15 and the appropriate ratio of the future liver remnant volume/total liver volume (%FLR) are considered candidates for major hepatectomy with biliary reconstruction