Laparoscopic resection of Bismuth type I and II hilar cholangiocarcinoma: an audit of 14 cases from two institutions. 
To evaluate the feasibility and safety of laparoscopic resection of Bismuth type I and II hilar cholangiocarcinoma.  Laparoscopic resection of hilar cholangiocarcinoma is uncommon.  Fourteen cases of Bismuth type I and II hilar cholangiocarcinoma were selected for laparoscopic resection.  Eight cases involved local resection and 6 cases included partial hepatectomy.  The mean operating time and blood loss were 305 min and 386 ml, respectively.  The R0 resection rate was 100 and 60% in patients with type I and II lesions, respectively.  The mean postoperative hospital stay was 9 days and 19 days in patients with type I and II tumor, respectively.  In-hospital mortality and morbidity were 0 and 35.7% (5 of 14 patients), respectively.  Bile leakage occurred in 1 of 7 (14.3%) and 3 of 5 (60%) patients with type I and II tumors, respectively.  Port-site metastases were found in 2 cases of type II tumor.  The survival rate during a 20-month follow-up period was 85.7% (12 of 14 patients).  Laparoscopic resection is a potential alternative to open surgery for appropriately selected patients with Bismuth type I hilar cholangiocarcinoma.  Due to the lower R0 resection and more complications, the value of laparoscopic resection for patients with type II tumors needs further evaluation.