[Operation treatment method of Bismuth-Corlette Ⅲ, Ⅳ hilar cholangiocarcinoma]

Hilar cholangiocarcinoma (HCCA) is also known as cancer at the upper part of bile duct, perihilar cholangiocarcinoma or Klatskin tumor, etc.Bismuth-Corlette type Ⅲ hilar cholangiocarcinoma refers to tumor invading right hepatic duct (Ⅲa) or left hepatic duct (Ⅲb). While Bismuth-Corlette type Ⅳ hilar cholangiocarcinoma refers to both left and right intrahepatic bile ducts being invaded. Under the premise of strictly grasping the indications of surgery, if preoperative management is conducted carefully, extended hepatic resection is a safe and feasible surgery to remove Bismuth-Corlette type Ⅲ and type Ⅳ hilar cholangiocarcinoma. When conducting extended hepatic resection, right hepatectomy and combined caudate lobectomy should be conducted depending on the circumstances. Routine skeletization lymph node dissection of the hepatoduodenal ligament is performed, which could be expanded into celiac trunk, para-aortic area and the rear of pancreatic head. In the premise of radical resection, invaded vessels should be removed and then reconstructed depending on circumstances.