Recent advances in surgical treatment of complex hilar cholangiocarcinoma

Complex hilar cholangiocarcinoma is a great challenge to surgeons in hepatic surgery, not only because of its great degree of operation difficulty, but also the high surgical risk and low R0 resection rate. Noticeably, R0 resection, lymph node infringement, and vessel resection are regarded as three independent prognostic factors for complex hilar cholangiocarcinoma. In recent years, with the advancement of surgical techniques such as precise liver resection using preoperative 3D imaging, application of radical tumor resection while preserving normal liver parenchyma for patients who are suitable for this surgical process, combined hepatic resection and vascular resection, and performance of reasonable extent of lymph node dissection, it is hoped to increase the curative resection rate for patients with Bismuth type Ⅲ and Ⅳcomplex hilar cholangiocarcinoma, improve their quality of life, and prolong their survival time.