胆道支架联合125I粒子置入与姑息性手术治疗晚期胆管癌的疗效比较

目的比较自膨式金属支架联合导管载入式125I粒子（SEMS-CL-125I）与姑息性手术（PS）治疗晚期肝外胆管癌（EHCC）的疗效。方法选择SEMS-CL-125I（SEMS-CL-125I组，n=67）或PS（PS组，n=34）治疗的晚期EHCC病人，比较2组术后并发症、住院时间、住院费用和总体生存率（OS）的差异。结果与术前相比，2组病人术后1、3、6个月血清TBIL、ALT、AST水平均降低，而ALB均升高（P < 0.05）。SEMS-CL-125I组术后1个月ALB水平显著高于PS组（P < 0.05）。2组术后总体并发症差异无统计学意义（P>0.05）。与PS组相比，SEMS-CL-125I组病人的住院时间明显缩短，住院费用明显减少（P < 0.01），OS显著改善（P < 0.05）。术前TBIL、CA19-9、ALB和治疗方法是与术后OS相关的主要因素。结论对于晚期EHCC病人，与PS相比，SEMS-CL-125I显著缩短了住院时间，降低了住院费用，延长了生存时间，值得临床推广和应用。

Comparison of therapeutic effect of biliary stent combined with 125I particle implantation and palliative surgery in the treatment of advanced cholangiocarcinoma

ObjectiveTo compare the efficacy of self-expanding metal stent combined with catheter loaded 125I particle (SEMS-CL-125I) and palliative surgery (PS) in the treatment of advanced extrahepatic cholangiocarcinoma (EHCC).MethodsPatients with advanced EHCC treated with SEMS-CL-125I (SEMS-CL-125I group, n=67) or PS (PS group, n 34) were selected.The postoperative complications, hospitalization time, hospitalization expenses and overall survival rate (OS) between the two groups were compared.ResultsCompared with that before operation, the levels of TBIL, ALT and AST in the two groups decreased at 1, 3 and 6 months after operation, while ALB increased (P < 0.05).The level of ALB in SEMS-CL-125I group was significantly higher than that in PS group at 1 month after operation (P < 0.05).There was no significant difference in postoperative complications between the two groups (P>0.05).Compared with PS group, The hospitalization time, hospitalization expenses and OS in SEMS-CL-125I group were significantly shorter than those in PS group (P < 0.01), and OS was significantly improved (P < 0.05).Preoperative TBIL, CA19-9, ALB and treatment method were the main factors related to postoperative OS.ConclusionsCompared with PS, SEMS-CL-125I significantly shortens the hospitalization time, reduces the hospitalization expenses and prolongs the survival time of patients with advanced EHCC, which is worthy of clinical promotion and application.