目的 :研究外科手术探查不能切除的原发性肝门部胆管癌作U型管引流 ,解除梗阻性黄疸 ,术后经U型管后装192 Ir腔内照射肿瘤 ,达到直接杀伤肿瘤效果。方法 :本组病例术中获取病理诊断 ,部分病例刮除管腔内肿瘤 ,经胆总管下段与肝面作U型管外引流 ,贯穿肿瘤上下有侧孔。术中银夹标记肿瘤范围 ,术后 2周左右经U型管后装192 Ir进行腔内照射治疗 ,剂量和疗程依据肿瘤大小确定 ,可重复治疗。结果 :影像学显示肿瘤局部控制优良率 87 5 % ,随访 2 4例中死亡 19例 ,生存期 6～ 2 6月 ,平均生存 12月 ,2年生存率 10 5 %。健在 5例 ,生存 8～ 34月 ,平均生存 18 2月 ,2 5年以上 2例 ,占 40 %。结论 :后装192 Ir腔内照射治疗不能切除的原发性肝门部胆管癌是一种有效的治疗方法 Objective: To study the surgical exploration of unresectable primary hilar cholangiocarcinoma for U-tube drainage to relieve obstructive jaundice. After operation, the tumor was irradiated with 192 Ir intracavity after the U-tube insertion to achieve direct tumor killing effect. Methods: The patients were pathologically diagnosed intraoperatively, in some cases curettage of intraluminal tumors, the lower part of the common bile duct and the liver surface for U-shaped drainage, through the tumor up and down side holes. Intraoperative silver clip mark the tumor range, after about 2 weeks after the U-tube 192 Ir for endovascular treatment, dose and treatment based on the size of the tumor can be repeated treatment. Results: Imaging showed that the tumor local control rate of 87 5%, followed up 24 cases were 19 cases of death, the survival of 6 to 2 months, the average survival in December, 2-year survival rate of 10 5%. Healthy in 5 cases, the survival of 8 to 34 months, the average survival 18 February, 2 5 years in 2 cases, 40%. Conclusion: Posterior 192 Ir intraluminal irradiation is an effective treatment for unresectable primary hilar cholangiocarcinoma