At present, the most effective treatment for extrahepatic cholangiocarcinoma is still surgical resection, but the biological behavior of cholangiocarcinoma determines its clinical characteristics of low resection rate. In particular, cholangiocarcinoma of the hilar region is more difficult to be surgically resected because it is in the extrahepatic bile duct and special location, which is often advanced once diagnosed. The literature reports that the cholangiocarcinoma that can be surgically resected ranges from 5% to 50%, with an average of 20%. 1.Pre-operative preparation: Because of the wide scope of resection for cholangiocarcinoma of the liver portal, in many cases, simultaneous lobectomy is required, and patients often have severe jaundice, malnutrition and low immune function, and patients with cholangiocarcinoma are generally older, so good pre-operative preparation is very important. 2.Surgical methods: The surgical methods of bile duct cancer resection are generally different according to the location and typology of the tumor. Type IV tumor invades widely and is difficult to resect, so total hepatectomy and liver transplantation can be considered. The caudate lobe is located behind the first hepatic hilar and its hepatic duct is short and close to the confluence of the hilar bile ducts. The distant metastasis of cholangiocarcinoma in the hilar region occurs later, but infiltration and spread along the bile duct and peri-bile duct tissues are very common. All bile duct cancers invading above the confluent hepatic duct are likely to invade the caudate lobe hepatic duct and liver tissue, with one group reporting 97% of cases. Therefore, caudate lobectomy should be the main component of radical resection for cholangiocarcinoma in the hilar region. Cholangiocarcinoma cells can either infiltrate directly or metastasize into the intra- and extra-hepatic bile ducts and connective tissue of hepatoduodenal ligament through blood vessels and lymphatic vessels or through the perineural space. Therefore, careful dissection and removal of nerve fibers and nerve plexus in the hilar region, sometimes even including the right abdominal ganglion, during surgical resection of cholangiocarcinoma should be one of the basic requirements for radical resection of cholangiocarcinoma. At the same time, the connective tissue in the hepatoduodenal ligament should be removed as thoroughly as possible together with the fatty lymphoid tissue to realize the “skeletonization” of the vessels in the hilar region. In recent years, the surgical resection rate of cholangiocarcinoma of the hilar region has been significantly improved, and the resection rate has increased from 10% in the past to about 50%.