Figure 1.

A 55-year-old female patient with cholangiocarcinoma and nodular metastases (cT2 cN1 cM1 (LYM)) received neoadjuvant chemotherapy with Gemcitabine and Cisplatin. Preoperative CT scan showed a stable disease with tumor in the right liver lobe (A) and infiltration of the right and middle hepatic vein (B). To augment the future liver remnant, a portal vein embolization was carried out prior the planned major hepatectomy. We performed a trisectionectomy (Segment I, IV–VIII) combined with replacement of the inferior vena cava and reinsertion of the left hepatic vein (C), using femoral-axillary bypass and portal hypothermic liver perfusion. A R0-resection was histopathological secured.