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目的：总结肝门部胆管癌手术切除的疗效及影响因素。方法：对本中心1978年1月～1997年12月手术切除97例肝门部胆管癌的切除方式、生存期、并发症及死亡率、术后复发转移等进行回顾性分析。结果：切除97例中根治切除51例，姑息切除46例。根治切除者1、3、5年生存率和复发转移率分别为95．00％、27．50％、17．50％和10．00％、75．00％、85．00％。姑息切除者为48．15％、7．41％、3．70％和77．78％、95．59％、100％，两组间比较有非常显著性差异P＜ 0．01。根治切除者1、3、5年生存率较姑息切除者显著提高，复发转移率显著降低。根治切除者手术并发症和死亡率分别为27．50％和7．84％，姑息切除者为36．96％和9．28％。两组间比较无显著性差异P ＞0．05。结论：根治切除是提高肝门部胆管癌生存率及减少复发转移的关键，合理的围手术期处理可降低根治切除术的并发症及死亡率。
Objective: To summarize the efficacy and influencing factors of surgical resection of hilar cholangiocarcinoma. Methods: A retrospective analysis was performed on the resection, survival, complications, mortality, postoperative recurrence and metastasis of 97 cases of hilar cholangiocarcinoma from January 1978 to December 1997. RESULTS: Among the 97 patients who underwent radical resection in 51 cases, 46 underwent palliative resection. The 1-, 3-, and 5-year survival rates and relapse metastasis rates of radical resection were 95.00%, 27.50%, 17.50%, and 10.00%, 75.00%, and 85.00%, respectively. The palliative resection was 48.15%, 7.41%, 3.70% and 77.78%, 95.59%, 100%. There was a very significant difference between the two groups (P<0.01). The 1-, 3-, and 5-year survival rate of radical resection was significantly higher than that of palliative resection, and the recurrence and metastasis rate was significantly reduced. The surgical complications and mortality for radical resection were 27.50% and 7.84%, respectively, and those for palliative resection were 36.96% and 9.28%. There was no significant difference between the two groups (P > 0.05). Conclusion: Radical resection is the key to improve the survival rate of hilar cholangiocarcinoma and reduce the recurrence and metastasis. Reasonable perioperative management can reduce the complications and mortality of radical resection.