【摘要】 肝门胆管癌，７０年代以前大多数病例难以切除，视为手术禁区。随着医学科学技术的快速发展，早期病例诊断率明显提高，手术切除率也提高至６０％左右。从１９８８～１９９６年共施行肝门胆管癌手术切除２６例取得较好效果。Ⅰ型（肝总管癌）１０例，Ⅱ型（肝管汇合部癌）７例，Ⅲ型（左肝管及肝总管癌）４例，Ⅳ型（右肝管及肝总管癌）３例，Ⅴ型（左、右肝管和肝总管癌）２例。手术方法为单纯肝门胆管癌切除，肝门胆管及半肝切除，肝中央部切除，扩大半肝切除后与空肠行Ｒｏｕｘ－ｅｎ－Ｙ吻合术。作者对手术切除方法，禁忌证，治疗效果等进行了详细讨论。所有病例均行胆管或肝断面与空肠吻合术，术后并发症少，再次手术少，疗效满意。更多还原

【Abstract】 From 1988 to 1996,26 cases of proximal bile duct cancers were treated　surgically with fair result. According to the classification of Bismuth and　Corlette there were 10 type I (common hepatic duct cancer) ; 7 type II (cancer　at the confluence of hepatic ducts);4 type III(left hepatic duct and common hepatic duct cancer);3 type IV(right hepatic duct and common hepatic duct　cancer).The surgery performed included simple excision of cancer at porta　hepatis,excision of portal bile duct and hemihepatectomy,central part　hepatectomy,extensive hemihepatectomy with Rouxeny anastomosis to jejunum.The　operative procedures,contraindications of surgery and therapeutic effects were discussed in detail. It is considered that hemihepatectomy with Rouxeny choledochoenterostomy is of choice with lesser complication,fewer chances of reoperation and satisfactory result.更多还原