肝门受累的肝内胆管癌 (ICCA) 是一种更具侵袭性的胆管癌，预后较差。1,2 切缘阴性的手术切除是 ICCA 唯一有效的治疗方法。3,4 新辅助治疗被认为可以提高手术可能性患者；5,6 然而，由于技术挑战，针对肝门受累的 ICCA 新辅助治疗后的腹腔镜根治性切除术仍处于探索阶段。7 方法：一名 19 岁男性因左侧肝部出现 ICCA侵犯肝门内的血管和胆管。在多学科团队确定肿瘤手术极其困难且风险很大后，进行了五个疗程的新辅助治疗。进行腹腔镜左肝切除术加尾叶切除术以完成阴性切缘的切除。三维可视化可以实现精确的术前计划和术中指导，包括肿瘤位置的可视化、胆管和血管解剖步骤的模拟以及确定肝脏切除的范围。术中进行血管骨架化、淋巴结清扫及胆道重建。手术时间415分钟，出血100mL。术后病理组织学证实为低至中分化的胆管癌。切除边缘呈阴性（R0），淋巴结病理学呈肿瘤阴性（0/10）。患者术后第10天出院，无并发症。对于肝门受累的ICCA新辅助治疗后腹腔镜根治性切除术在大通量肝外科中心是安全可行的。© 2024。外科肿瘤学会。

Intrahepatic cholangiocarcinoma (ICCA) with hepatic hilus involvement is a more aggressive type of cholangiocarcinoma with worse outcomes.1,2 Surgical resection with negative margins is the only effective treatment for ICCA.3,4 Neoadjuvant therapy is considered to improve the possibility of surgery for patients;5,6 however, laparoscopic radical resection after neoadjuvant therapy for ICCA with hepatic hilus involvement remains at the exploratory stage due to technical challenges.7 METHODS: A 19-year-old man presented with an ICCA on the left side of the liver invading the blood vessels and bile ducts in the hepatic hilum. Five courses of neoadjuvant therapy were administered after a multidisciplinary team determined that the tumor was extremely difficult and risky to operate on. A laparoscopic left hepatectomy plus caudal lobectomy was performed to complete the resection of the negative margins. Three-dimensional visualization enabled precise preoperative planning and intraoperative guidance, including visualization of the tumor location, simulation of bile duct and vessel dissection steps, as well as determining the extent of liver resection. Vascular skeletonization, lymphadenectomy and biliary reconstruction were performed during operation.The operation time was 415 min with a blood loss of 100 mL. Postoperative pathohistology confirmed cholangiocarcinoma with low to intermediate differentiation. The resection margin was negative (R0) and lymph node pathology was tumor-negative (0/10). The patient was discharged on postoperative day 10 without complications.Laparoscopic radical resection after neoadjuvant therapy for ICCA with hepatic hilus involvement is safe and feasible in a large-throughput hepatic surgery center.© 2024. Society of Surgical Oncology.