目的　探讨经手术切除肝门胆管癌 (hepatichilarcholangocarcinoma ,HHCC)手术切缘有无残癌对预后的影响。　方法　比较切缘有残癌组 (4 3例 )和无残癌组 (4 0例 )患者的临床分型、手术方式、肿瘤分化程度及生存情况。　结果　切缘有残癌组患者 1、2、3和 5年生存率 ,分别为 37 2 %、6 3%、3 5 %和 2 4% ;切缘无残癌组患者分别为 82 2 %、5 8 2 %、41 6 %和 2 7 7%。　结论　手术切缘残癌率与肿瘤分化程度关系密切 ,在BismuthⅣ型中发生率最高。BismuthⅣ型中的低分化型腺癌患者 ,手术切除疗效差 ,对无肝外转移者可以选择肝移植术 Objective To investigate the effect of surgical resection of hepatic hilar cholangiocarcinoma (HHCC) surgical margin on the prognosis. Methods The clinical classification, surgical methods, tumor differentiation and survival of patients with residual margin (43 cases) and non-residual cancer group (40 cases) were compared. Results There were 1-2, 3, and 5-year survival rates in the residual cancer group at the margin, which were 372%, 637%, 35%, and 24%, respectively; 82% of patients with no residual cancer at the margin were found. 5 8 2 %, 41 6 % and 27 7 %. Conclusions The residual cancer rate at the surgical margin is closely related to the degree of tumor differentiation, with the highest incidence in Bismuth IV. Patients with poorly differentiated adenocarcinoma of type Bismuth IV have poor surgical resection and can choose liver transplantation for patients without extrahepatic metastases.