分析Bismuth-Corlette Ⅱ型肝门部胆管癌（HCCA）行扩大肝切除与围肝门切除的临床疗效及预后，探讨其合理的治疗策略。

采用回顾性研究的方法，收集2014年1月至2021年6月新疆医科大学第一附属医院消化血管外科中心经手术治疗的35例Bismuth-CorletteⅡ型HCCA患者的临床资料。根据手术方式的不同，分为扩大肝切除组（15例）和围肝门切除组（20例）。观察和记录术前一般资料、术中和术后情况以及随访情况。采用Kaplan-Meier曲线和Log-rank检验进行生存分析，并对影响患者预后的因素进行单因素和Cox比例风险模型多因素分析。

两组术前一般资料和术中输血需求、血管切除重建方面差异均无统计学意义，但手术时间、术中出血量、术后住院天数、术后并发症比较，差异均有统计学意义（P<0.05）。35例随访25（11，32）个月，扩大肝切除组1、2、3年累积生存率分别是86.7%、71.5%、59.6%，围肝门切除组分别为65.0%、43.3%、27.1%，两组术后生存率差异无统计学意义（χ²=2.799，P=0.094）。单因素分析结果显示TNM分期、血管侵犯是影响Ⅱ型HCCA患者预后的相关因素（P<0.05），以上因素经多因素分析后差异无统计学意义。

扩大肝切除和围肝门切除治疗Bismuth-CorletteⅡ型HCCA都是可行的，两种手术方案具有相似的安全性与有效性，但扩大肝切除患者有长期生存率的优势。

To analyze the clinical efficacy and prognosis of extended hepatectomy and perihilar hepatectomy for Bismuth-Corlette typeⅡ hilar cholangiocarcinoma (HCCA), and to explore the reasonable treatment strategy.

This is a retrospective follow-up study. The clinical data of 35 patients with Bismuth-Corlette typeⅡ HCCA who underwent surgical treatment in the Digestive and Vascular Surgery Center of the First Affiliated Hospital of Xinjiang Medical University from January 2014 to June 2021 were collected. According to different surgical methods, they were divided into extended hepatectomy group (15 cases) and perihilar hepatectomy group (20 cases). General preoperative information, intraoperative and postoperative conditions, as well as follow-up data were observed and recorded. The survival analysis was performed using Kaplan-Meier curve and Log-rank test. Single factor and Cox proportional risk model multivariate analysis were conducted to analyze the factors affecting the prognosis of patients.

There were no statistically significant differences between the two groups in terms of preoperative general information, intraoperative blood transfusion requirements, vascular resection and the reconstruction. However, there were statistically significant differences between the two groups in terms of surgical time, intraoperative blood loss, postoperative hospitalization days, and postoperative complications (P<0.05). All 35 patients were followed up for 25 (11, 32) months. The 1-, 2-, and 3-year cumulative survival rates in the extended hepatectomy group were 86.7%, 71.5%, 59.6%, respectively, while those in the perihilar hepatectomy group were 65.0%, 43.3%, 27.1%, respectively. There was no statistically significant difference in the postoperative survival rates between the two groups (χ²=2.799, P=0.094). The results of univariate analysis showed that TNM stage and vascular invasion were related factors affecting the prognosis of patients with type Ⅱ HCCA (P<0.05), while the above factors had no statistically significant difference after multivariate analysis.

Both extended hepatectomy and perihilar hepatectomy for Bismuth-Corlette type Ⅱ HCCA are viable. The two surgical schemes have similar safety and efficacy, but extended hepatectomy has the advantage of long-term survival in patients.