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作者对１９７８年至１９９５年收治的６３例肝外胆管癌患行进行了诊断与治疗方面的探讨。本组患者的平均年龄为４３．５岁，男女之比为２．９：１。在病理分型中，浸润型癌占５６％，结节型占３８％，乳头状型占６％。根据发生部位分类：在胆总管上部者占５８．７％，中部占１７．５％，下部占２３．８％。本组全部患者均依靠临床表现及Ｂ超获初步诊断，但梗塞的具体部位及范围往往需ＣＴ或其它介入性方法如ＰＴＣ、ＥＲＣＰ或血管造影等得出。我们不主张术前取细胞学检查，无论是怀疑为良性还是恶性病变，均施行剖腹探查手术。肝外胆管癌的切除率低，特别是上部胆管癌的切除难度更大。本组总切除率为４７．６％，其中上部胆总管癌为２８．７％，中部为６３．６％；下部为８０％。对无法切除者采用姑息性引流术或置管术以改善患者的生活质量，并为其它治疗如化疗、放疗创造条件。
The author investigated the diagnosis and treatment of 63 cases of extrahepatic cholangiocarcinoma admitted from 1978 to 1995. The average age of the patients in this group was 43.5 years, and the ratio between men and women was 2.9:1. In the pathological type, invasive cancer accounted for 56%, nodules accounted for 38%, and papillary type accounted for 6%. According to the location of the occurrence: 58.7% in the upper common bile duct, 17.5% in the middle, and 23.8% in the lower part. All patients in this group rely on clinical manifestations and B-ultrasound to obtain a preliminary diagnosis, but the specific location and extent of infarcts often require CT or other interventional methods such as PTC, ERCP, or angiography. We do not advocate the use of cytology before surgery. Whether suspected of being benign or malignant, laparotomy is performed. The removal rate of extrahepatic bile duct cancer is low, especially the removal of upper bile duct cancer is more difficult. The total resection rate was 47.6% in this group, with 28.7% in the upper common bile duct cancer, 63.6% in the middle, and 80% in the lower part. Palliative drainage or catheterization is used to improve the patient’s quality of life for unresectable patients, and to create conditions for other treatments such as chemotherapy and radiotherapy.