肝门周围胆管癌是一种少见肿瘤,预后不良.因其邻近肝动脉、门静脉及常有肝受累,很难切除干净;有人主张放疗.以往回顾性分析提示肝门周围胆管癌辅助放疗可改善生存期,但报告中的病人多属小肿瘤,可以切除,一般情况较好,而不作放疗者情况较差,不可切除或有转移.作者进行前瞻性研究,决定肝门周围胆管癌手术切除加放疗对生存期、生活质量及晚期毒性的效果.自1988至1993年,选择肝门周围癌拟手术者,无转移,Karnofsky计分>60,以往无恶性病、未行放疗者,门脉主干通畅,共50例.分为切除组31例,姑息手术组19例;放疗23例,不加放疗27例.切除组肿瘤较小(1.9±2.8cm),姑息术组(2.4±2.1cm),切除组比姑息术组较不易侵犯肝动脉(3%比42%).不易侵犯门脉(6%比53%).放疗与不放疗两组病人多种参数(年龄、性别、种族、合并病、症状体征等)均相近.50例都在术前经皮穿肝置入内支撑管引流胆道数天至30天不等.术式包括肿瘤完全切除、肝切除、Roux-Y式胆管空肠吻合术、 Perithecal cholangiocarcinoma is a rare tumor with a poor prognosis. Because of its proximity to the hepatic artery, portal vein and often liver involvement, it is difficult to remove it cleanly; Some people advocate radiotherapy. Previous retrospective analysis suggested that adjuvant radiotherapy for peribbal cholangiocarcinoma can be improved. Survival, but most of the patients in the report are small tumors, can be removed, generally better, without radiotherapy, the condition is poor, unresectable or metastasis. The authors conducted a prospective study to determine the surgical removal of perianbal cholangiocarcinoma plus Effects of radiotherapy on survival, quality of life, and late toxicity. From 1988 to 1993, hepatic cancer patients were selected who had no metastases, Karnofsky score was >60, no previous malignancy, no radiotherapy, portal vein Smooth, a total of 50 cases. Divided into a resection group of 31 cases, 19 cases of palliative surgery group; radiotherapy in 23 cases, no radiotherapy in 27 cases. Resection group tumors smaller (1.9 2.8cm), palliative surgery group (2.4 +/- 2.1cm) The resection group was less likely to invade the hepatic artery than the palliative group (3% vs. 42%). It was not prone to invade the portal vein (6% vs. 53%). Radiotherapy and non-radiotherapy groups had multiple parameters (age, sex, race, merger). Diseases, signs and symptoms, etc.) are similar. 50 cases were percutaneously inserted into the internal support tube before the operation. Biliary flow ranging from several days to 30 days. Procedures include complete resection, liver resection, Roux-Y Formula choledochojejunostomy,