目的　探讨改善成人胆管囊肿癌变恶劣预后的措施。方法　回顾总结了过去 34年间2 4例胆管囊肿癌变诊治经验。结果　 2 4例 (男 5例 ,女 19例 )均手术治疗 :肝外囊肿切除 +胰十二指肠切除 5例 ;肝外囊肿切除 6例 ;13例因癌变广泛行各种姑息手术。住院死亡 2例。失访 2例。随访死亡 16例 ,平均存活时间 11个月。 4例仍存活 ,已分别存活 12 ,7,6 .5 ,0 .5年。结论　 (1)对成人BDCS癌变早期诊断、争取治愈性切除是改善其预后的关键。 (2 )对成人BDCS尤其是作过内引流术者积极预防性囊肿切除对防止癌变有重要的意义 Objective To explore measures to improve the poor prognosis of adult malignant bile duct cysts. Methods Review and summarize the experience of diagnosis and treatment of 24 cases of bile duct cysts in the past 34 years. Results Twenty-four patients (five males and 19 females) were treated with surgery: extrahepatic cyst resection + pancreaticoduodenectomy in 5 cases; extrahepatic cyst resection in 6 cases; and 13 cases with extensive palliative surgery for canceration. 2 patients died in hospitalization. Missed 2 cases. Follow-up death occurred in 16 patients and the average survival time was 11 months. Four patients were still alive and had survived 12, 7, 6 .5, and 0.5 years respectively. Conclusions (1) Early diagnosis of adult BDCS cancer and seeking curative resection is the key to improve its prognosis. (2) Active prophylactic cystectomy for adults with BDCS, especially for internal drainage, is important to prevent canceration