[The value and controversy of hepatopancreatoduodenectomy in the treatment of cholangiocarcinoma].

Cholangiocarcinoma is a highly aggressive malignancy with a poor prognosis, and surgical resection remains the only potentially curative treatment. Hepatopancreatoduodenectomy (HPD) represents a radical surgical option for selected patients with locally advanced cholangiocarcinoma involving both the perihilar region and the peripancreatic bile duct. Although HPD can increase the resection rate and the likelihood of achieving R0 margins, it is associated with substantial perioperative mortality and morbidity, and its survival benefit remains controversial. In recent years, advances in surgical techniques and perioperative management have improved the safety of HPD, allowing a subset of carefully selected patients to achieve long-term survival. However, HPD has not yet been established as a standard treatment for locally advanced cholangiocarcinoma and should be performed with caution under strict indications in high-volume centers. This review summarizes current evidence regarding the indications, surgical strategies, perioperative safety, and survival outcomes of HPD in the management of cholangiocarcinoma.