Background The resection and reconstruction of the hepatic artery is often required in radical surgery for hilar cholangiocarcinoma. In this study, we report our experience in performing arterioportal shunting as an altative for the arterial reconstruction.Methods Four patients with hilar cholangiocarcinoma underwent extended left hepatectomy and caudate Iobectomy combined with en bloc resection of the hepatic artery and arterioportal shunting with restriction of the arterial caliber. The efficacy of arterioportal shunting was assessed by computed tomography angiography (CTA).Results All the four patients recovered uneventfully without any complications. CTA showed a patent shunt and normal liver regeneration. No signs of portal hypertension were found at one year of follow-up.Conclusions Arterioportal shunting with restriction of the arterial caliber appears to be a feasible and safe altative for the microvascular reconstruction after hepatic artery resection in radical surgery for hilar cholangiocarcinoma.