Early carcinoma of the biliary tract was defined as cancer cell invasion limited to the mucosal or muscularis propria in the case of the gallbladder, to the mucosal or fibro-muscular layer in the case of carcinoma of the bile duct and to the sphincter of Oddi in the case of the papilla of Vater from a study on the correlation between the depth of cancer invasion and the result of surgery. A few cases, however, have lymph node metastasis, venous invasion, perineural infiltration or involvement of the lymphatic vessels. The surgical procedures should therefore be selected in order to have a good chance for long-term survival. The importance of systematic lymph node dissection to improve survival is emphasize, even in patients with early biliary tract cancer.