Hepatopancreatoduodenectomy for locally advanced perihilar cholangiocarcinoma: A case report and a plea not to underestimate surgical resectability

• Cholangiocarcinomas are characterized by low resectability most often due to late presentation; • Longitudinally spreading cholangiocarcinoma can extend from the biliary plate to the intrapancreatic choleducus, being difficult to treat radically either with liver resection or pancreatoduodenectomy; • Hepatoduodenopancreatectomy can treat locally advanced cholangiocarcinomas, but is characterized with a high rate of complications and few cases are performed in the Western world; • Locally advanced cholangiocarcinomas should be evaluated in a high volume and skill HPB surgical centre; • Clinical management must address potential complications (e.g. liver failure) in order to minimize failure to rescue from complications.