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作者对55例肝外胆管癌的治疗方法与预后的关系进行临床探讨。按Longmire分型，上段、中段、下段胆管癌分别占43．6％、21．8％、346％；有42例得到病理诊断。手术切除11例（26．2％），“减黄”手术30例（胆肠内引流14例，外引流16例），单纯剖腹，PTCD、非手术保守治疗分别为1、6、7例。随访1～62个月，随访率87．3％。平均生存时间10．8±9．7个月；手术切除组生存时间最长（21．4±16．7个月，P＜0．01），生存率最高（P＜005）；胆肠内引流组的生存时间（12．2±6．8个月）和生存率亦明显高于其它各组（P＜0．05）。因此，对有条件的肝外胆管癌，应争取早期作根治性切除＋胆管空肠吻合，并酌情切除受累肝脏；即使无根治条件，亦应尽可能作胆肠内引流。
The authors investigated the relationship between the treatment of 55 extrahepatic cholangiocarcinomas and their prognosis. According to the Longmire classification, the upper, middle, and lower segments of the bile duct cancer accounted for 43.6%, 21.8%, and 346%, respectively; 42 cases were diagnosed pathologically. Surgical resection was performed in 11 cases (26.2%), “reduction of yellow” in 30 cases (intra-biliary draining in 14 cases, external drainage in 16 cases), and simple laparotomy. PTCD and non-surgical conservative treatment were 1, 6, and 7 cases, respectively. Follow-up was 1 to 62 months. The follow-up rate was 87.3%. The average survival time was 10.8±9.7 months. The longest survival time was in the surgical resection group (21.4±16.7 months, P<0.01). The survival rate was highest (P<005); The survival time (12.2±6.8 months) and survival rate of the drainage group were also significantly higher than those of other groups (P<0.05). Therefore, for conditional extrahepatic cholangiocarcinoma, early radical resection + biliary jejunostomy should be pursued, and the affected liver should be removed as appropriate; even if there is no radical condition, intraductal drainage should be performed as much as possible.