OBJECTIVETo summarize the experience of surgical treatment of the hilar cholangiocarcinoma and explore the factors influencing the operative effect.

METHODSFifty-three cases of hilar cholangiocarcinoma performed operation from January 1998 to January 2008 were divided into two groups: Group I included cases treated from January 1998 to December 2002 (totally 22 cases); Group II included cases treated from January 2003 to January 2008 (totally 31 cases). Comparative study was carried out between these two groups.

RESULTSSurgical resection [radical resection (R(0)) + palliative resection (R(1))] rate in group I was lower than that in group II (40.9% vs. 71.0%, P = 0.029). Hepatic lobectomy rate in group I was lower than that in group II (30.0% vs. 64.5%, P = 0.016). The resection rate was positively correlated with the hepatic lobectomy rate (r = 0.985, P < 0.01). The median survival time of the patients underwent R(0) resection was longer than that in the patients underwent R(1) resection and palliative bile duct drainage [(27.0 +/- 4.5) months vs. (10.0 +/- 0.7) months vs. (4.0 +/- 0.5) months, respectively, P < 0.01].

CONCLUSIONSEarly diagnosis and radical resection are important to improve the prognosis for patients with hilar cholangiocarcinoma. But for the patients could only receive palliative resection or with positive celiac trunk lymph nodes, combined liver lobe resection could not improve the survival.