Incorporating palliative care can significantly impact procedural decisions for patients with hepatopancreatobiliary cancers.

• Among 2,848 patients, 48.2% underwent inpatient procedures; 40.7% received palliative care.
• Early palliative care involvement correlated with a 29% lower chance of undergoing nonpalliative procedures (odds ratio 0.71).

Greater integration of palliative care may enhance decision-making aligned with patient quality of life at the end of life.

• Palliative care use more than doubled from 2013 to 2024, but procedural rates remained constant.