Abstract: Objective The aim of this study was to investigate CT three-dimensional reconstruction technology in guiding surgical resection of perihilar cholangiocarcinoma(PHCC). Methods 96 patients with PHCC were encountered in our hospital between June 2019 and June 2024, and all underwent CT scan for three-dimensional reconstruction, and tumor resection thereafter. Results Seventy-two patients (75.0%)with PHCC in our serieshad actually had their tumor resected, and the sensitivity (Se), specificity (Sp) and accuracy (Ac) of CT three-dimensional reconstruction in evaluating the resectability of PHCC were 97.2%, 54.2% and 86.5%; based on histopathological classification, the Ac of CT three-dimensional reconstruction in judging Bismuth-Corlette classification was 91.6%; histopathological examination found artery, portal, venous invasion and lymph node metastasis in 25 cases, 28 cases, 10 cases and 15 cases out of the 72 patients with resected tumors; the Se were 92.0%, 92.0%, 90.0% and 86.7%, Sp were 89.4%, 90.9%, 96.8% and 89.5%, and Ac were 90.3%, 90.3%, 95.8% and 88.9% by CT three-dimensional reconstruction in judging artery, portal, venous invasion and lymph node metastasis. Conclusion Three-dimensional CT reconstruction in determining resectability of PHCC pre-operationally is helpful for clinicians making appropriate surgical decisions.

Key words: Perihilar cholangiocarcinoma, CT three-dimensional reconstruction, Bismuth-Corlette typing, Surgery