目的：研究肝Ｂｉｓｍｕｔｈ Ⅲ型肝门胆管癌根治性切除时，需要伴同切除肝脏的范围。方法：对两家医院近两年半来收治的ＢｉｓｍｕｔｈⅢ型肝门胆管癌３１例进行分析。其中２１例行根治性切除者，伴同左半肝切除１１例，伴同右半肝切除５例，伴同右三叶切除２例，伴同Ⅳ肝段切除３例。与上述各种肝切除合并作尾叶切除者９例。结果：全组无手术死亡，并发膈下脓肿２例，经穿刺置管引流治愈；并发肝衰腹水８例，其中右半肝切除后３例，左半肝切除后３例，右三叶切除后２例，均经强化护肝治疗、反复多次输注血浆和白蛋白治愈；并发胆漏３例，经保守引流而愈。施行Ⅳ肝段＋尾叶切除的３例顺利恢复，无并发症。结论： ＢｉｓｍｕｔｈⅢ型肝门胆管癌根治性切除伴同肝切除的范围应根据肿瘤所在的确切部位以及同侧门静脉有无受侵犯而定，尽量避免大范围的肝切除。 OBJECTIVE: To study the extent of hepatectomy in the treatment of hepatic Bismuth III hilar cholangiocarcinoma with radical resection. Methods: Thirty-one cases of Bismuth type III hilar cholangiocarcinoma treated in two hospitals in the past two and a half years were analyzed. Among them, 21 patients underwent radical resection with 11 cases of left hemihepatectomy, 5 cases with right hemihepatectomy, 2 cases with right tricusectomy, and 3 cases with same IV segment resection. Combined with the above-mentioned various hepatic resection, 9 cases were treated by tail resection. RESULTS: There were no operative deaths in the whole group. There were 2 cases of subphrenic abscesses, which were cured by puncture and drainage. Eight cases were complicated with hepatic failure, including 3 cases after right hemihepatectomy, 3 cases after left hemihepatectomy, and right tricusectomy. In the last 2 cases, all of them were treated with hepatoprotective therapy, repeated infusions of plasma and albumin, and 3 cases of bile leakage were complicated by conservative drainage. Three patients who underwent resection of the IV segment and the tail lobe were successfully recovered without complications. Conclusion: The range of radical resection of Bismuth type III hilar cholangiocarcinoma with hepatectomy should be based on the exact location of the tumor and whether the ipsilateral portal vein is invaded. Try to avoid large-scale hepatectomy.