Abstract
The limit of ductal resection in hepatectomy for hilar cholangiocarcinoma is the most peripheral point where the hepatic ducts can be separated from the vasculature. The limit is also different for each type of hepatectomy because the portal vein branches that should be preserved or divided vary with the extent of the hepatectomy. The limits of ductal resection could be changed in patients with anomaly of the intrahepatic bile duct system. In patients with invasive type of cholangiocarcinoma, operative procedure should be determined by evaluating whether the ductal portion of the beginning of tapering extends the estimated ductal resection limit on the precise cholangiography. Meanwhile in patients with intraepithelial cancer spread, the margin of the cancer is sometimes difficult to be diagnosed preoperatively. In such cases multimodal assessment and mapping biopsy should be performed taking into account the ductal resection limits so as to diagnose the spread of the cancer and to select an appropriate operative procedure.
