目的探讨老年人Ⅲ、Ⅳ型肝门部胆管癌的有效手术治疗方法。方法回顾总结12例老年人Ⅲ、Ⅳ型肝门部胆管癌采用距肿瘤边缘长约1cm处切断肝内胆管并切除距肿瘤边缘1cm肝组织的手术方法。结果全组患者无围术期死亡及术后胆瘘、吻合口瘘等严重并发症发生,术后1年和2年生存率分别为66.7%、41.7%。结论距肿瘤边缘长约1cm处切断肝内胆管并切除距肿瘤边缘1cm的肝组织的方法是老年人Ⅲ、Ⅳ型肝门部胆管癌的有效方法。 Objective To investigate the effective surgical treatment of type Ⅲ and type Ⅳ hilar cholangiocarcinoma in the elderly. Methods The retrospective summary of 12 elderly patients with type Ⅲ, Ⅳ hilar cholangiocarcinoma using the tumor from the edge of about 1cm at the cut off the intrahepatic bile duct and resection of the tumor from the edge of 1cm liver surgical methods. Results There were no perioperative deaths, serious postoperative complications such as bile fistula and anastomotic leakage. The 1-year and 2-year survival rates were 66.7% and 41.7% respectively. Conclusion The method of cutting off the intrahepatic bile duct about 1cm from the edge of the tumor and removing 1cm away from the edge of the tumor is an effective method for hilar cholangiocarcinoma of the elderly.