目的　分析 B超、CT等方法对肝门部胆管癌的诊断价值 ,探讨肝门部胆管癌早期诊断方法及病理类型与患者生存期的关系。方法　根据病情术前对 48例肝门部胆管癌分别经 B超、CT、经内窥镜逆行性胰胆管造影、经皮肝穿刺胆道造影等方法进行探查 ,并结合肝功能、血清癌胚抗原等检查 ,评估肿瘤的生长状况。根据肿瘤的部位和浸润转移的情况 ,分别采用根治性手术、姑息性手术和非手术治疗。手术标本皆经病理学检查。结果　 1B超对肝门部胆管癌诊断的准确率达 93.8%。2肝门部胆管癌中 ,低分化腺癌及粘液腺癌所占的比例较高 ,为 6 5 .8% (2 5 /38)。3低分化腺癌发生肝转移和周围淋巴结、神经及血管浸润转移率明显高于高分化腺癌 ,平均生存期较高分化腺癌短。 4手术切除率为 36 .8% ,高分化腺癌切除组患者的生存期高于非手术治疗组。结论　 B超对肝门部胆管癌的诊断有较高的价值 ,肝门部胆管癌病理类型与预后明显相关。 Objective To analyze the value of B-ultrasonography and CT in the diagnosis of hilar cholangiocarcinoma, and to explore the early diagnosis methods and pathological types of hilar cholangiocarcinoma and its relationship with survival time. Methods According to the condition, 48 cases of hilar cholangiocarcinoma were preoperatively examined by B-ultrasonography, CT, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, and combined with liver function and serum CEA. And other tests to assess the growth of the tumor. According to the location of the tumor and the invasion and metastasis, radical surgery, palliative surgery and non-surgical treatment were used. Surgical specimens were examined by pathology. Results The accuracy of 1B ultrasonography in diagnosis of hilar cholangiocarcinoma was 93.8%. In the hilar cholangiocarcinoma, the proportion of poorly differentiated adenocarcinoma and mucinous adenocarcinoma was higher, 65.8% (25/38). 3 The poorly differentiated adenocarcinoma showed hepatic metastasis and peripheral lymph node, nerve and vascular infiltration metastasis rate was significantly higher than that of well-differentiated adenocarcinoma, and the average survival time was higher than that of differentiated adenocarcinoma. 4 The resection rate was 36.8%. The survival time of patients with well-differentiated adenocarcinoma resection group was higher than that of non-surgical treatment group. Conclusion B-ultrasound has a high value in the diagnosis of hilar cholangiocarcinoma, and the pathological type of hilar cholangiocarcinoma is obviously related to prognosis.