Background : Cancer of the bile duct, cholangiocarcinoma(CCA), can occur anywhere along the biliary tract from the ampulla of Vater to the intrahepatic biliary radicals. Klatskin’s tumors, actually-redefined as perihilar cholangiocarcinoma (phCCA) do represent 50–70% of all CCAs and develop in a context of chronic inflammation and cholestasis of bile ducts. Surgical resection provides the only chance of cure for this disease but is technically challenging because of the complex, intimate and variable relationship between biliary and vascular structures at this location. Although laparoscopic technology has been increasingly used in almost all abdominal surgeries in recent years, laparoscopic phCCA surgery has rarely been reported in the relevant literature involving the complex operations is really difficult to perform by laparoscopic surgery. We present the case of a man diagnosed with a klatkin’s tumor due to an episode of painless jaundice.

Methods : In this case, 75-year-old male patient was diagnosed with type 4 Klastkin tumor by computed tomography scan and Magnetic Resonance Imaging. The video shows the surgical technique of a laparoscopic extended left hepatectomy with biliary resection and hilar lymphadenectomy in a patient. The parenchymal transection is performed with a Cavitron Ultrasonic Surgical Aspirator (CUSA) under intermittent clamping. The biliary reconstruction technique utilized is a Roux-en-Y hepaticojejunostomy.

Results : The operative time was 400 min, and the estimated blood loss was 800mL. The patient had no operation related complication in postoperative days, and she was discharged on postoperative day 6.

Conclusions : Laparoscopic technology in the surgical treatment of phCCA is an option for the resection approach.