Abstract: Extended liver resection may provide long term survival in selected patients with hilar cholangiocarcinoma. In May 2013, a patient with hilar cholangiocarcinoma received right hemihepatectomy combined with caudate lobectomy under the guidance of precision hepatectomy technique. The porta hepatis was clamped in the operation for 3 times intermittently. The operation time was 8 hours, and the volume of intraoperative blood loss was 600 mL. The patient was discharged at postoperative day 14. The results of pathological examination confirmed that the patient had moderately highly differentiated adenocarcinoma with full thickness infiltration of the bile duct and tumor free margins. No tumor recurrence was detected during the follow up which was lasted for 6 months. The operation was carried out based on the three dimensional reconstruction, liver reserve function evaluation, intraoperative controlled low central venous pressure and precision hepatectomy technique, and the results were satisfactory.