Abstract
Klatskin tumors are cholangiocarcinomas which arise at the biliary bifurcation (perihilar cholangiocarcinoma). Due to the close anatomical relationship to the liver parenchyma, portal bifurcation and hepatic arteries, the treatment of these tumors represents a major challenge. The only curative treatment option so far is the complete surgical removal of the affected bile ducts. This often warrants an en bloc liver resection sometimes in combination with resection and reconstruction of the portal vein and occasionally of the hepatic artery. A regional lymphadenectomy is mandatory. The operations are technically challenging and associated with a significant perioperative morbidity up to 50-60% and mortality of around 10%.