晚期肝门部胆管癌手术治疗和介入治疗疗效观察

目的:观察并对比晚期肝门部胆管癌手术治疗和介入治疗的疗效。方法:将75例晚期肝门部胆管癌患者按治疗方法的不同分为介入组(n=36)和手术组(n=39),分别接受经皮经肝胆管引流联合内支架植入术(PTBD+stent)和手术切除治疗,对两组患者的临床资料和随访资料进行回顾性分析,对比两种治疗方法的疗效。结果:手术组和介入组术后血清总胆红素水平均显著低于各自术前水平,差异有统计学意义,但两组间术前、术后血清总胆红素水平比较差异无统计学意义;术后随访期内,手术组平均生存时间和95%可信区间均高于同期介入组,但组间比较差异无统计学意义。结论:对晚期肝门部胆管癌患者采用介入治疗是一种姑息性疗法,可获得与手术切除治疗相近的生存时间,而且具有操作简单、手术风险低和微创等优点。

Observation of the efficacy between surgical treatment and interventional therapy for advanced hilar cholangiocarcinoma

Objective：To observe and compare the efficacy between surgical treatment and interventional therapy for advanced hilar cholangiocarcinoma.Methods：75 cases of advanced hilar cholangiocarcinoma were divided into intervention group （36 cases） and surgical group （39 cases） according to the different treatment,they were treated by PTBD combined with stent implantation and surgical resection respectively.Clinical data and follow-up data of two groups were analyzed retrospectively,comparing the efficacy of two treatment methods.Results：The postoperative serum total bilirubin of surgical and intervention group were both significantly lower than their preoperative levels,the difference was statistically significant,but the comparison of serum total bilirubin level before surgery or after sugery between the two groups had no statistically significant;the average survival time and 95% confidence interval of the surgical group in postoperative follow-up period were higher than intervention group,but between the two groups there was no statistically significant difference.Conclusions：Interventional therapy for the treatment of advanced hilar cholangiocarcinoma is a kind of palliative treatment,it can get a similar survival time as surgery treatment,and it has unique advantages such as simple,low-risk and minimally invasion and so on.