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Abstract Background: The efficacy of major hemihepatectomy for advanced gallbladder carcinoma is still controversial, because of a high risk of postoperative serious complications and a poor prognosis. On the other hand, extended major hepatectomy has been frequently applied for hilar bile duct cancer or cholangiocarcinoma involving the hepatic hilus.Methods: Between 1999 and 2009, thirty five patients underwent extended right hemihepatectomy for gallbladder carcinoma involving the right Glisson’s sheath or the hepatic hilus and/or with direct invasion of the liver parenchyma. Extended right hemihepatectomy included resection of inferior part of Couinaud’s segment IV and entire caudate lobe with extra-bile duct resection and lymph node dissection with connective tissue in the hepatoduodenal ligament. The clinicopathological data of all the patients were analyzed retrospectively. Two patients with apparent residual cancer were excluded from the recurrent and survival analysis. Gallbladder cancer originating from cystic duct was defined as cystic duct carcinoma when the center of the tumor mass was located in the cystic duct by the final pathological examination. Results: Twenty five patients (74%: 28/35) presented with jaundice. There was no mortality, but morbidity occurred in 16 patients (46%). Operative time and bleeding was 564 ± 206 minutes and 1472 ± 1268 ml, respectively. There was no red cell blood transfusion in 28 patients (80%: 28/35). The distribution of the tumor stages according to the TNM classification (UICC 6th) was: stage IIA (n = 4: 12%), II B (n =4: 12%), III (n =14: 42%), IV (n = 11: 34%). The overall 5-year survival rate and mean survival was 19.9% and 3.4±0.7 years, respectively. Three patients (9%) survived more than five years. On multivariate analysis, presence of hepatic metastases and gallbladder carcinoma originated from cystic duct were a significant indicator of a poor prognosis.Conclusions: This procedure contributed long-term survival in the selected patients with safe. Hepatic metastases seem to be a contra-indicator for surgery, because no patients survived more than 2.2 years.