Abstract

A 68 year old man with hilar cholangiocarcinoma had undergone a left hepatic lobectomy and hilar bile duct resection with hepaticojejunostomy. The right hepatic duct and the common bile duct were macroscopically excised at 1 cm and 2 cm distal from the margin of the cancer; respectively, however, cancer invasion was histologically positive at the stump of the right hepatic duct.The first and second group of lymph nodes were dissected. Metastasis was detected in all dissected lymph nodes. After the operation the patient could live with a good quality of life for five years.There after the patient had fever and abdominal pain and retrograde cholangitis was suspected. Six months later, the patient ultimately died of renal failure due to cancer invasion of both side of the ureters, however, there vvas no sign of the obstructive jaundice.