Abstract: Objective To investigate the safety and effectiveness of preoperative PTBD therapy for radical resection of hilar cholangiocarcinoma combined with hepatectomy. Methods Clinical data about 112 patients who underwent radical resection of hilar cholangiocarcinoma combined with hemihepatectomy admitted to our hospital from January to December in 2013 were retrospectively analyzed. Then their preoperative condition, operation status and postoperative complications were summarized and analyzed. Results No statistically significant was found in positive rate of bacteria through culturing the bile which collected intraoperative between the two groups (χ²=0.054，P=0.816). The preoperative total bilirubin (TB) of group PTBD and group NPTBD was (107.1±29.6) μmol/L and (135.6±85.2) μmol/L, respectively. There was statistical significance in two groups (t=2.13, P=0.035). The incidence of bile leakage after operation in group PTBD was lower than that of group NPTBD (χ²=4.952, P= 0.026). Although the rate of postoperation complication such as incision infection, hepatic insufficiency in group PTBD was lower than that of group NPTBD, the difference made no statistical significance. Conclusion PTBD is a safe and effective method to alleviate the symptoms of jaundice. It can significantly improve the patients' preoperative liver function and nutritional state and reduce the incidence of postoperative bile leakage.