手术切除仍然是胆管癌病例实现长期生存的唯一方法。对于此类病例，普遍认可的标准手术包括胰十二指肠切除术（PD）或半肝切除术并伴有胆管重建。尽管如此，一些患者仍然可以通过胆管节段切除术（BDR）达到治疗目的。然而，这些手术仍处于试验阶段，仅建议仔细选择的患者使用。一名 57 岁的男性患者在两周黄疸加剧和腹部不适后入住我们科室。入院时，总胆红素为 102 μmol/L，直接胆红素为 87 μmol/L。他的碳水化合物抗原 19-9 (CA 19-9)、癌胚抗原 (CEA) 和甲胎蛋白 (AFP) 水平正常。增强计算机断层扫描 (CT) 和磁共振成像 (MRI) 扫描显示胆管树增厚且增强，从胆囊管交界处延伸至肝总管，三维重建显示无血管侵犯。患者接受了腹腔镜肝外切除术胆管切除术，并伴有根治性淋巴结切除术、骨骼化和胆道重建，在 320 分钟内成功完成，失血量最少，仅 50 毫升。该手术的组织学分级为T2bN0M0（II期）。患者术后第六天出院，无并发症。此后，他接受了单药卡培他滨化疗方案。经过 18 个月的随访，未观察到复发。我们的经验表明，在选定的诊断为中胆管胆管癌的患者中，腹腔镜切除有可能达到骨架化淋巴结切除的标准。© 2023。外科肿瘤学会。

Surgical resection remains the sole approach to achieving long-term survival in cholangiocarcinoma cases. The universally recognised standard procedures for such cases include pancreaticoduodenectomy (PD) or hemihepatectomy accompanied by bile duct reconstruction. Nevertheless, some patients may still attain curative intent through bile duct segmental resection (BDR). However, these procedures are still in the experimental stage and should only be recommended for carefully chosen patients.A 57-year-old male patient was admitted to our department after two weeks of escalating jaundice and abdominal discomfort. Upon admission, his total bilirubin was recorded at 102 μmol/L, and his direct bilirubin was 87 μmol/L. His carbohydrate antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA) and alpha fetoprotein (AFP) levels were normal. Enhanced computed tomography (CT) and magnetic resonance imaging (MRI) scans revealed a thickened and enhanced biliary tree extending from the cystic duct junction to the common hepatic duct no vascular invasion indicated by three-dimensional reconstruction.The patient underwent laparoscopic resection of the extrahepatic bile duct, accompanied by radical lymphadenectomy with skeletonisation and biliary reconstruction, was successfully conducted within 320 min, with a minimal blood loss of only 50 ml. The histological grading of the procedure was T2bN0M0 (stage II). The patient was discharged on the sixth postoperative day without complications. Following this, he underwent a regimen of single-agent capecitabine chemotherapy. After an 18-month follow-up period, no recurrence was observed.Our experience suggests that in selected patients diagnosed with middle bile duct cholangiocarcinoma, laparoscopic resection could potentially reach the standard of lymphadenectomy through skeletonisation.© 2023. Society of Surgical Oncology.