The patient, female, 42 years old, was admitted to the hospital on 2009-04-17 with “intermittent epigastric pain and discomfort for 1 month and yellow sclera staining for 2 weeks”. On April 5, 2009, she developed dark urine and itchy skin, and on April 12, she developed yellow sclera staining. “cholecystitis, hepatoportal occupancy”, MRI examination found: “intrahepatic bile duct extension, isometric T1, isometric T2 solid occupancy in the hepatoportal area”, elevated bilirubin, our hospital as “obstructive jaundice The patient was admitted to the hospital with “obstructive jaundice”. After admission, we perfected all laboratory tests, performed CTA, tumor markers, etc. Diagnosis: 1) obstructive jaundice: 1) gallbladder cancer 2) bile duct cancer in the hilar region. 2) cholecystitis, 2009-4-21 under general anesthesia, wedge resection of the 4th and 5th segments of the liver, gallbladder and common bile duct resection, partial resection of the head of the pancreas and the hooks, and Roux-en-Y anastomosis of the pancreas and the jejunum of the intrahepatic bile duct Pathological findings: gallbladder neck, The size of the mass was 7×5×3 cm. The tumor tissue infiltrated the adjacent liver tissue, pancreatic head tissue and peripheral nerve tissue. No tumor was found in the cut edges of the liver and pancreas, in the cut edges of the (distal) common bile duct, the left and right hepatic ducts and portal vein wall, and in the (hooked) pancreatic tissues on frozen examination. Metastatic hypofractionated adenocarcinoma in the lymph nodes around the neck of the gallbladder (1/2). A large infiltration of adenocarcinoma tissue with sheet necrosis was seen in the fibrous connective tissue of the head of the pancreas and the posterior duodenal lymph nodes on cryopreservation, with local involvement of pancreatic tissue. Chemotherapy was administered with a regimen of Kenzer 1g IV on days 1 and 8 and Siroda 1.5g orally 2 times/day on days 1-14, in a 3-week cycle. The follow-up was normal at 1 year after surgery.