目的　探讨治疗肝门胆管癌理想的肝叶切除术式 ,以期提高其疗效、降低并发症和病死率。方法　对 16例侵犯肝门血管的肝门胆管癌 ,采用肝I ,IV段连同肝门胆管肿瘤与受侵血管整块切除及肝十二指肠韧带骨骼化淋巴清扫。结果　 15例获手术切除 ,切除率为 93 .8% ,12例获R0 切除。无手术死亡和住院死亡。发生暂时性胆漏 1例 ,腹腔感染 1例 ,并发症发生率为 13 .3 % ,均行非手术治愈。随访病例中位生存期为 2 2个月 ,7例尚存活。结论　合并肝叶、肝门血管切除可提高肝门胆管癌的切除率和生存率 ;肝中叶和肝尾叶是肝门胆管癌手术联合切除的主要部位。肝门受侵血管的切除对提高该病切除率和根治率是有意义的 ,应酌情重建或不重建肝门血管。 Objective To investigate the ideal hepatectomy for the treatment of hilar cholangiocarcinoma in order to improve its curative effect and reduce complications and mortality. Methods Sixteen cases of hilar cholangiocarcinoma invading the hilar vessels were treated with hepatic I and IV together with resection of the hilar cholangiocarcinoma and the invading blood vessel and dissecting the hepaticoduodenal ligament. Results 15 cases were surgically removed, the resection rate was 93.8%, 12 cases were R0 resection. No operative and hospitalized deaths. One case of transient bile leakage, one case of abdominal infection, the complication rate was 13.3%, were non-surgical cure. The median survival time was 22 months and 7 survived. Conclusions The combined hepatic lobectomy and hepatic portal resection can improve the resection rate and survival rate of hilar cholangiocarcinoma. The middle lobe and caudate lobe are the main sites for the surgical resection of hilar cholangiocarcinoma. Excision of the hilar invading vessels is of significance in improving the excision and cure rates of the disease, and hepatic vessels should be reconstructed or not, as appropriate.