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目的：探讨不同手术方式对于IV期胆囊癌患者远期预后的影响作用。 方法：回顾性分析手术治疗的134例IV期胆囊癌患者的临床与随访资料，其中采用姑息切除术44例（姑息手术组）、采用胆囊癌根治术或扩大根治术治疗56例（根治性手术组）、胆道内外引流术治疗34例（引流组），比较3组患者的远期预后情况。 结果：对于IVa期胆囊癌患者，3组的术后1年生存率差异无统计学意义（P>0.05），但根治性手术组的术后3年生存率明显高于姑息手术组和引流组（17.2%vs.0.0%vs.0.0%，均P<0.05）；根治性手术组术后的中位生存时间18个月，明显长于姑息手术组（14个月）和引流组（12个月）（χ2=12.094；14.876，均P0.05）；根治性手术组术后的中位生存时间14个月，明显长于姑息手术组（9个月）和引流组（9个月）（χ2=8.741，χ2=8.839，均P0.05), but the postoperative 3-year survival rate in radical surgery group was signiifcantly higher than that in palliative surgery group or drainage group (17.2%vs. 0.0%vs. 0.0%, both P<0.05). hTe median postoperative survival time in radical surgery group was 18 months, which was signiifcantlylonger than that in palliative surgery group (14 months) and drainage group (12 months) (χ2=12.094; 14.876, bothP0.05); the median postoperative survival time in radical surgery group was 14 months that was signiifcantly longer than that in palliative surgery group (9 months) and drainage group (9 months) (χ2=8.741; 8.839, bothP<0.05). Conclusion: Early radical resection may be helpful for improving the long-term outcomes of patients with stage IV gallbladder carcinoma.