In the treatment of hilar cholangiocarcinoma, several studies have advocated en bloc major hepatectomy to achieve negative histologic margins and improved survival. Since these extended surgical procedures have serious problems, including high morbidity, especially with postoperative liver failure, various parenchyma-preserving hepatectomy procedures with potential curability have been proposed, such as caudate lobectomy alone, caudate lobectomy combined with medial or anterior segmentectomy, and central bisegmentectomy. This chapter covers the difference between hilar plate resection (HPR) and conventional hilar bile duct resection (CHBDR), indication of hilar plate resection, diagnosis, surgical procedure, and surgical outcome.