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Objective: To assess the effect of biliary drainage of the future liver remnant (FLR) and to develop a risk score for postoperative mortality after liver resection for perihilar cholangiocarcinoma (PHC). Methods: A consecutive series of 287 patients submitted to major liver resection for presumed PHC between 1997 and 2014 at two Western centers was analyzed; 228 patients (79%) underwent preoperative drainage for jaundice. FLR volumes were calculated with CT volumetry, and completeness of FLR drainage was assessed on imaging. A risk score was developed using multivariable logistic regression with five pre-defined variables. Results: Postoperative mortality at 90-days was 14%. Incomplete FLR drainage was a risk factor only in patients with an FLR volume below 50% (OR 2.8, 95% CI 1.1-7.5). No postoperative mortality was observed in 33 undrained patients with FLR volumes above 50%, including 10 jaundiced patients (median bilirubin level 188 mmol/L). Age,