Seventy-nine patients with extrahepatic malignant cholangiocarcinomas were treated at the Surgical Clinic of the Charité from 1981 to 1989. Thirty-two of these patients suffered from Klatskin tumour. Exact preoperative staging includes sonography, CT scan, cholangiography (PTC or ERCP). Angiography can help to clear the diagnoses. Sixteen patients were considered inoperable. The therapy was surgical bypass, surgically or percutaneously placed catheters and endoscopically placed endoprostheses, a median survival time was 2 to 6 months. The other 16 patients underwent 12 resections and four liver transplantations. Two of these transplanted patients are still tumour-free, their survival times ranging from 2 to 6 years. The median survival time of the patients undergoing resection amounts to 22 months and operation mortality, 12%. Optimal treatment strategies by the Klatskin tumours is the radical resection.