Aim: The aim of our study was to asses results of surgical treatment of perihilar cholangiocarcinoma with (Group 1) and without (Group 2) portal vein invasion. Materials and Methods: From 2003 to January 2021 in the Department of Surgery and Liver Transplantation of the Ukrainian National Institute of Surgery and Transplantation, 166 patients with perihilar cholangiocarcinoma underwent major extended liver resections. We compared 78 (47%) patients who received extended liver resection with portal vein resection with 88 (53%) patients who underwent liver resections without vascular reconstructions. 103 (62%) patients were male, 63 (38%) patients were female. The average age of patients in the group 1 was 57 (37 – 81) years in the group 2 of 57.1 (26 – 74) years. The average Ca 19–9 in the group 1 was 288 (8 – 1000) U/ml, in the group 2 – (10 – 612) 262 U/ml. The level of total bilirubin in patients of the group 1 was 312 (43 – 621) mcmol/l, in the group 2 – 267 (10 – 612) mcmol/l. In view of this, in the preoperative period, 116 (88.5%) patients underwent decompression of the bile ducts, using percutaneous transhepatic cholangiostomy (PTBD) or retrograde endobiliary stenting. For patients with small remnant liver volume less than 40 %, in 58 cases we did preoperative PVE of a resected part of the liver. In 9 cases we made simultaneous PVE and PTBD. When choosing the volume of surgical intervention, we proceeded from the tumor type of Bismuth-Corlette classification, invasion into the portal vessels and the depth of the liver lesion. The portal vein reconstruction was in all cases performed in an “end-to-end”. In all cases we made extended lymphadenectomy. According to a histological study, metastatic lesion of 1-3 regional lymph nodes (N1) was detected in 9 (14.7%) patients, 4 or more (N2) – in 2 (3.3%) patients. All complications were classified according to the Dindo-Clavien classification. Postoperative mortality in the main group was 11.5%. The overall 1, 3, 5-year survival in the group 1 was 86.8%, 58%, 50%, respectively. 1, 3, 5-year survival rate in the comparison group was 85.6%, 56%, 42%, respectively. Conclusion: Aggressive surgical treatment for cholangiocarcinoma the confluence of bile duct with portal vein resection can be performed safely with acceptable lethality and long-term survival rate.