目的　探讨提高原发性胆囊癌的治疗效果。方法　对 1981年 1月～ 1995年 12月收治的经病理证实的原发性胆囊癌 6 6例的临床及随访资料进行分析。结果　 6 2 %的病例合并有胆囊结石 ,右上腹疼痛 ,黄疸及右上腹包块是最常见的症状和体征。B超和CT有助于术前诊断。病理检查显示腺癌占 79% ,早期肿瘤细胞分化程度相对较好 ,晚期肿瘤占 6 9%。 5 2 %的病例病灶已无法切除 ,根治性手术仅占 16 % ,少数晚期患者经根治性手术可以获得长期生存。统计学分析显示肿瘤的病理分期、肿瘤细胞分级、手术方式与预后显著相关。结论　重视胆囊癌的诊断 ,适当扩大早期胆囊癌的手术切除范围 ,对晚期胆囊癌尽可能行根治性切除术 ,可望改善其预后 Objective To explore the therapeutic effect of primary gallbladder cancer. Methods The clinical and follow-up data of 66 pathologically confirmed primary gallbladder carcinomas admitted from January 1981 to December 1995 were analyzed. RESULTS: Sixty-two percent of the cases had gallstones and pain in the right upper quadrant. Jaundice and right upper quadrant masses were the most common symptoms and signs. B-mode ultrasound and CT help preoperative diagnosis. Pathological examination showed that adenocarcinoma accounted for 79%, early tumor cell differentiation was relatively good, advanced tumors accounted for 69%. In 52% of cases, the lesions have not been removed, radical surgery accounts for only 16%, and a few advanced patients can survive long-term after radical surgery. Statistical analysis showed that the tumor’s pathological stage, tumor cell grading, surgical methods and prognosis were significantly correlated. Conclusion The importance of the diagnosis of gallbladder cancer, the appropriate expansion of the scope of surgical resection of early gallbladder cancer, radical gallbladder cancer as long as possible radical resection, is expected to improve its prognosis