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本文报告２６例高位胆管癌患者。根据肿瘤部位分为Ⅰ、Ⅱ、Ⅲ和Ⅳ型。手术方式包括：以肿瘤为中心的肝内外胆管大范围切除后行肝肠Ｒｏｕｘ－Ｙ内引流。肿瘤局部切除，肿瘤外胆管架桥内引流，经胆囊床切开右肝内胆管行胆囊空肠吻合内引流，经肝外胆管强行通过肿瘤插管外引流等。本组手术切除率为７６．９％，明显高于其他作者的报告。我们认为，提高高位胆管癌手术切除率的关键在于早期诊断；手术方式以根治性肿瘤切除后肝肠Ｒｏｕｘ－Ｙ内引流术最佳；内引流效果明显优于外引流。在手术前后应用中药可以降低血中内毒素水平，保护肾功能，降低应激性胃粘膜病变的发生率，并可起到荡涤大肠糟粕、流通肠道和利胆消黄的功效。
This article reports 26 patients with high cholangiocarcinoma. According to the tumor site is divided into Ⅰ, Ⅱ, Ⅲ and Ⅳ type. Surgical methods include: the tumor-centered intrahepatic bile duct resection after a wide range Roux-Y internal drainage. Tumor resection, the tumor drainage within the outer biliary stent, the gallbladder bed incision of the right hepatic duct gallbladder jejunostomy drainage, extrahepatic bile duct forced drainage through the tumor intubation and so on. This group of surgical resection rate was 76.9%, significantly higher than the other authors report. In our opinion, the key to improve the surgical resection rate of high cholangiocarcinoma lies in the early diagnosis. Roux-Y internal drainage is the best surgical method after radical tumor resection. The internal drainage is better than the external drainage. Application of Chinese medicine before and after surgery can reduce the level of endotoxin in blood, protect renal function, reduce the incidence of stress gastric mucosal lesions, and can play the role of cleaning the bad dregs, intestinal circulation and gallbladder yellow.