目的　探讨肝门部胆管癌多种术式对患者预后的影响。方法　回顾性分析我院 1992年 12月～ 1999年 5月收治的 35例经手术和病理证实的肝门部胆管癌病人手术方式和随访结果。结果　本组手术切除 13例 ,胆管内引流 5例 ,外引流 11例 ,仅剖腹探查 6例。有随访资料的 2 3例 ,随访率 6 5 .7%。手术后生存最短 2 8d ,最长 30个月。切除术 (根治切除和姑息切除 ) 13例存活 7～ 30个月 ,中位生存期 15个月 ,1、2年生存率为 76 .9%、30 .8%。引流组存活 2 .5～ 2 4个月 ,中位生存期 8个月 ,1、2年生存率为 2 0 .6 %、14.3%。单纯剖腹探查术多于术后 3个月内死亡。至今生存 5例 ,生存期分别为 12、13、13、15和 2 1个月。结论　根治性切除和扩大切除范围是肝门部胆管癌最佳治疗方法。不放弃手术探查机会 ,对不能切除的病例 ,争取胆道内、外引流 ,可延长生存时间 ,提高生活质量 Objective To investigate the effect of multiple surgical procedures of hilar cholangiocarcinoma on the prognosis of patients. Methods Retrospective analysis of 35 surgical and pathologically confirmed cases of hilar cholangiocarcinoma admitted to our hospital from December 1992 to May 1999 were retrospectively analyzed. Results The group of surgical resection in 13 cases, 5 cases of biliary drainage, external drainage in 11 cases, laparotomy only 6 cases. There were 23 cases of follow-up data, follow-up rate of 65.7%. Survival after surgery the shortest 2 8d, up to 30 months. Excision (radical resection and palliative resection) 13 patients survived 7 to 30 months, the median survival of 15 months, 1, 2-year survival rate was 76.9%, 30.8%. The drainage group survived 2.5 to 24 months, with a median survival of 8 months. The 1-year and 2-year survival rates were 20.6% and 14.3%, respectively. Laparotomy alone more than 3 months after the death. Five patients have survived to date with a survival of 12, 13, 13, 15 and 21 months, respectively. Conclusions Radical resection and extended resection are the best treatment for hilar cholangiocarcinoma. Do not give up the chance of surgical exploration, can not be removed cases, for bile duct, drainage, can extend the survival time and improve the quality of life