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Objective: The aim of the study was to compare the effects of several kinds of diagnosis and treatment measures on hilar cholangiocarcinoma. Methods: The 136 patients with hilar cholangiocarcinoma were operated in our hospital (Department of Hepatobiliary Surgery, Affiliated Hospital of Luzhou Medical College, China) from 1990 to 2011. Among of them, 48 cases with tumour resection, 9 cases with intrahepatic biliary-enteric bypass, 61 with external biliary drainage, 18 with exploration. Results: The total in-hospital mortality was 0%. The 97 cases were follow-up after operation: in 44 patients with tumour resection (15 with positive margins, 29 with negative margins), 1, 2, 3 years survival rates were respectively 58.26%, 28.34% and 6.38%; 43 patients with biliary drainage (7 patients with intrahepatic biliary-enteric bypass, 28 cases with external and jejunostomy, 8 patients with simple external biliary drainage), 1, 2 years survival rates were respectively 30.39% and 0%. Ten patients with exploration died within 21-68 days. Conclusion: To combine cholangiopancreatography, ultrasonography and Burke T-staging have practical value for assessment for tumour resectability. To resect a piece of wedge hepatic tissue but not total segment I might gain the effect of increasing curative resection and reserving segment I hepatic tissue.