目的 探讨肝门部胆管癌手术并发症的影响因素。

Objective To analyze prognostic factors for postoperative complications of hilar cholangiocarcinoma(HCC). Methods A retrospective clinical analysis was conducted in 49 patients with hilar cholangiocarcinoma, who were admitted to Beijing Aerospace Central Hospital between June 2000 and May 2010. Univariate and multivariate analysis was carried out. Results 23patients(46.9%) with HCC experienced postoperative complications, the most common of which was bile leakage(28. 1% ),followed by intraabdominal infection(18. 8% ) and pleural effusion(15. 6% ) and wound infection(12.5% ). 3 patients(6%) died after operatiopn. A total of 13 possible prognostic factors were analyzed. Univariate analysis showed that significant prognostic factors for postoperative complications in patients with HCC were combined hepatectomy（P=0.017）, vascular resection and reconstruction（P=0.026）, operative time（P=0.033）, Bismuth-Corlette (B-C) type（P=0.001）,operative blood loss（P=0.003）, and blood transfusion（P=0.017）. Multivariate analysis indicated combined hepatectomy（P=0.011）, operative time（P=0. 027） and operative blood loss（P=0. 022）as independent prognostic factors. Conclusion Accurate preoperative assessment, intensive perioperative management, use of time-saving surgical techniques, and the reduction of operative blood loss and the surgical extent for the patients with HCC will significantly reduce the incidence of postoperative complications.