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高位胆管癌，我国由本世纪７０年代中叶进入手术切除的历史，首批切除率为５．３％和８．３％。本文作者的首批切除率为７５．０％（２４例中的１８例）；手术切除肿瘤后的最短生存时间为１３个月１７天，生存的最长时间达３６个月１２天；肿瘤未切除者的生存时间最长为６个月。手术切除难度按Ⅰ、Ⅱ、Ⅲ、Ⅳ型顺序递增，生活质量，肿瘤切除者多数为＂优＂，未切除者多数属＂差＂。黄疸消退状况，肿瘤切除者ＴＢｉＬｉ降至正常或接近正常值；未切除者的ＴＢｉＬｉ的变化状况，则以腹腔内肿瘤外肝肠架桥内引流和胆囊肝床切开右侧肝内胆管胆囊空肠内引流者为好，可使ｋＴＢｉＬｉ接近正常，经肿瘤强行插管外引流者有所下降，而经右肝大囊肿空肠支架内引流者ＴＢＩＬｉ术后继续升高。
High-grade cholangiocarcinoma, China entered the history of surgical resection in the mid-1970s. The first resection rate was 5.3% and 8.3%. The authors’ first resection rate was 75.0% (18 out of 24 cases); the shortest survival time after surgical resection was 13 months and 17 days, and the longest survival time was 36 months and 12 days; The longest survival time of the resected person is 6 months. The difficulty of surgical resection was increased in the order of I, II, III, and IV. The quality of life and tumor resection were mostly “excellent”, and those who were not resectable were “poor.” Jaundice dissipated, TBiLi of tumor resection was reduced to normal or near normal values; TBILi of unresected patients was changed to intraperitoneal tumor outside the liver and intestinal drainage and gallbladder liver bed incision of right intrahepatic bile duct gallbladder jejunum If the drainage is good, kTBiLi will be close to normal, and those who have been forced to intubate by the tumor will have decreased. However, the TBILi will continue to rise after the right hepatomegaly cyst in the jejunum stent drainage.