材料和方法:(1)病例情况,1982～1987年间对104例进行术中放疗,其中15例病理证实为胆管腺癌。男9例,女6例,年龄中位值为61岁。大部患者(13例)首发症状为胆管梗阻症象。近端胆管和远端胆管癌各5例,3例为胆囊胆管癌。2例来自胆囊癌,12例为原发肿瘤,3例复发肿瘤。9例无转移,6例有转移。(2)手术方式,自扩大切除术(胆总管加肝叶切除术)至剖腹探查术不等,所有患者均行胆肠吻合术。(3)放射治疗,以305KVP治疗机施行术中放疗15例,其中8例系再次手术时放疗。肉眼残留的和未切除的肿瘤照射深度为2～5cm,总量为5～50Gy。13例进行了术后外放疗,照射范围为胆管病变及肝门周围和腹腔淋巴结。面积为8×8～12×12 Materials and Methods: (1) Cases. Intraoperative radiotherapy was performed on 104 cases from 1982 to 1987, of which 15 cases were pathologically confirmed as bile duct adenocarcinoma. There were 9 males and 6 females. The median age was 61 years old. The first symptom in most patients (13 cases) was biliary obstruction. There were 5 cases of proximal bile duct and 5 cases of distal bile duct cancer. Three cases were gallbladder cholangiocarcinoma. Two cases were from gallbladder carcinoma, 12 were primary tumors, and 3 were recurrent tumors. Nine cases had no metastases and 6 cases had metastases. (2) Surgical methods, ranging from extensive resection (common bile duct plus hepatectomy) to exploratory laparotomy, all patients underwent biliary-enteric anastomosis. (3) Radiation therapy: Intraoperative radiotherapy was performed with a 305KVP machine in 15 cases, of which 8 cases were treated with radiotherapy during reoperation. Residual and unresected tumors with naked eyes have an irradiation depth of 2 to 5 cm and a total amount of 5 to 50 Gy. Thirteen patients underwent external radiotherapy after surgery. The radiation range was biliary lesions and periaportal and abdominal lymph nodes. Area is 8×8～12×12