Background/Aims: Extended right lobectomy and caudate lobectomy of liver with extrahepatic bile duct resection have been recommended to achieve radicality and improve prognosis in Bismuth type I and II hilar bile duct carcinoma. However, this extended hepatectomy could cause an excessive surgical stress for patients with reduced hepatic function and those in poor general condition who have suffered from prolonged and severe jaundice. In this study, outcomes in 5 patients treated with limited liver resection were evaluated to ascertain whether similar positive results comparable to extended liver resection could be obtained. Methods: For 5 instances, we had performed limited liver resection, called "central hepatectomy: caudate lobectomy in 1, central bisegmentectomy with Sl in 2, and medial segmentectomy with Sl in 2(1 of them underwent left portal vein resection and reconstruction using external iliac vein interposition graft). Results: In all instances, curative resections defined with cancer-negative resection margins were achieved. Their postoperative course and long-term survival were comparable to those of extended hepatectomy, and the longest survivor of the five patients has been alive for 46 months without recurrence. Conclusions: Central hepatectomy can be carried out with similar positive results to extended hepatectomy, especially in high-risk patients with limited functional liver reserve. (Korean J Gastroenterol 1995;27: 573 - 580)