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目的 多数外科医生对中晚期胆囊癌的外科治疗持消极悲观态度，作者探讨积极采取外科治疗的价值。方法 对３２ 例中晚期胆囊癌患者进行积极的外科治疗，除胆囊切除外，另行肝段切除术７ 例、半肝切除１ 例、肝门部胆管切除高位胆肠吻合４ 例、肝段切除并肝门部胆管切除高位胆肠吻合６例、肝部分及胰头十二指肠切除１４ 例。其中２６ 例行肝十二指肠韧带骨骼化清扫。结果 手术均顺利完成，１７ 例１２ 个月前手术者，１０ 例仍存活，其中２ 例已超过３０ 个月，最长达４０ 个月；１５ 例１２ 个月内手术者１４ 例存活。结论 对中晚期胆囊癌积极进行根治性手术，能改善其生活质量，延长生存期。
Objective Most surgeons are negative and pessimistic about the surgical treatment of advanced gallbladder cancer. The authors explore the value of aggressive surgical treatment. Methods Thirty-two patients with advanced gallbladder cancer underwent active surgical treatment. In addition to cholecystectomy, 7 patients underwent hepatectomy, 1 patient underwent hemihepatectomy, 4 patients with hepatic hilar bile duct resection, and 4 patients underwent hepatectomy. 6 cases of hilar biliary-enteric anastomosis of hilar bile duct resection and 14 cases of liver and pancreatic head duodenum were removed. Twenty-six of them underwent skeletal dissection of the hepatoduodenal ligament. Results All the operations were completed successfully. Of the 17 patients who had surgery 12 months earlier, 10 were still alive. Two of them had been more than 30 months and the longest was 40 months. Among the 15 patients who had surgery within 12 months, 14 survived. Conclusion Active radical surgery for advanced gallbladder cancer can improve the quality of life and prolong survival.