胆道125I 粒子支架与金属裸支架治疗Bismuth Corlette Ⅲ型胆管癌合并梗阻性黄疸的临床对比

  目的  对比胆道125I粒子支架与金属裸支架治疗Bismuth Corlette Ⅲ型胆管癌合并梗阻性黄疸疗效。  方法  回顾性收集自2010 年 1月至 2018年 6月期间于云南省肿瘤医院微创介入科进行治疗的所有由Bismuth Corlette Ⅲ型胆管癌引起的恶性胆道梗阻患者共51例，其中125I粒子支架植入组（观察组）25例，金属裸支架植入组（对照组）26例，比较2组术前术后肝功能、并发症发生率、患者支架通畅时间及生存期。  结果  125I粒子支架植入组（观察组）与金属裸支架植入组（对照组）患者术后1月肝功能及黄疸程度均明显改善；观察组较对照组术后并发症发生率并未增加；观察组的平均支架通畅时间为（369.20±231.64） d，中位支架通畅时间为310.05 d，对照组的平均支架通畅时间为（194.57±118.09） d，中位支架通畅时间为142.52 d，观察组患者支架通畅时间明显长于对照组（P < 0.05）；观察组平均生存期为（334.24±193.38） d，中位生存期为385.21 d，对照组平均生存期为（251.23±182.51） d，中位生存期为274.43 d，观察组患者生存期明显长于对照组（P < 0.05）。  结论  胆道125I粒子支架较金属裸支架在不增加术后并发症的基础上可显著降低支架再狭窄率，延长支架的通畅时间，提高患者生存期。

Clinical Comparison of Biliary Iodine-125 Stent and Bare Metal Stent in Treatment of Bismuth Corlette III Cholangiocarcinoma Complicated with Obstructive Jaundice

  Objective  To compare the efficacy of biliary 125I seed stent and bare metal stent in the treatment of Bismuth Corlette Ⅲ cholangiocarcinoma complicated with obstructive jaundice.   Methods  A total of 51 patients with malignant biliary obstruction caused by Bismuth Corlette Ⅲ cholangiocarcinoma who were treated in our department from January 2010 to June 2018 were systematically retrospectively collected, of whom 25 were in the 125I seed stent implantation group （observation group）. There were 26 cases in the bare metal stent implantation group （control group）, and the preoperative and postoperative liver function, complication rate, stent patency time and survival time were compared between the two groups.   Results  The liver function and jaundice degree of patients in the 125I seed stent implantation group （observation group） and bare metal stent implantation group （control group） were significantly improved at 1 month after surgery. Compared with the control group, the observation group did not increase the incidence of postoperative complications. The average stent patency time in the observation group was （369.20±231.64） d, and the stent patency time was 310.05 d in the control group, the average stent patency time in the control group was （194.57±118.09） d, and the median stent patency time was 142.52 d. The stent patency time in the observation group was significantly longer than that in the control group （P＜0.05）. The median survival period was （334.24 ± 193.38） d, and the median survival period was 385.21 d. The average survival period of the control group was （251.23 ± 182.51） d, and the median survival period was 274.43 d. The survival period of patients in the observation group was significantly longer than that in the control group （P＜0.05）.   Conclusion  Compared with bare metal stent, biliary 125I seed stent can significantly reduce stent restenosis rate, prolong stent patency time, and improve patient survival without increasing postoperative complications.