The authors summarize, based on an analysis of treatment of 12 patients with cancer of the extrahepatic biliary pathways in the area of the confluence of the hepatic bile ducts, contemporary problems of the diagnosis and treatment of this serious condition. From comparison of the authors’ small group with the most up-to-date procedures in the diagnosis and treatment of Klatskin’s tumour ensue the following facts: 1. Contrary to other departments in the world, in our country MRI is little used in diagnosis. In the diagnosis dominate ERCP, PTC and CT. 2. Except for Japanese authors standard preoperative treatment does not comprise drainage of the biliary pathways neither PTD nor a nasobiliary drain by the ERCP route. 3. At the time of assessment of the diagnosis the majority of patients is already inoperable. Thus stenting and brachytherapy predominate. 4. The majority of biliary affections is type III and IV according to Bismuth and from this ensues also the more difficult resectability. 5. Surgical operations, in particular those associated with hepatic resections have a high postoperative morbidity. 6. Preoperative histological diagnosis is very difficult. Without it adjuvant and palliative oncological treatment is not possible. 7. The prognosis of patients with Klatskin’ s tumour is generally bad.

        Key words: Katskin’s tumour – surgery – brachytherapy