Comparison Of The Curative Effects Of Intracavitary Combined Therapy And Palliative Surgery For Cholangiocarcinoma

Objective To evaluate the clinical efficacy of biliary stent combining 125 I seed intracavity irradiation and palliative surgery in treating cholangiocarcinoma.Methods A prospective analysis of 142 patients with cholangiocarcinoma cancer treated in our hospital Hepatobiliary Surgery from January 2012 to December 2015.There were 80 cases of percutaneous biliary metal stent combined with 125 I particles implantation(the stenting-particle group).62 patients(R1 resection in 17 cases,R2 resection in 26 cases,biliary enteric drainage in 19 cases)were treated by palliative biliary drainage(the surgical group).The levels of jaundice,liver function,survival time,hospitalization time and hospitalization cost before and after therapy were included in analysis to find out whether there has statistic difference between them.Results Both groups can effectively reduce the jaundice after a short period of time.The liver function of patients in both groups improved significantly at 1,3,and6 months compared with that before operation,differences observed were statistically significant(P<0.05).The average hospitalization time of the stenting-particle group and the surgery group was(16.50±4.95)days and(25.48±10.45)days respectively,the difference was statistically significant(t=-6.250,P<0.01).The average cost of hospitalization of the stenting-particle group and the surgery group was(39622±7666.40)yuan and(59562±24218.22)yuan respectively,the difference was statistically significant(t=-3.101,P<0.05).The average survival time of the stenting-particle group and the surgery group was(12.19±5.10)months and(12.69±7.46)months respectively,the difference was not statistically significant(t=-0.458,P=0.648).There were significant differences in survival time and hospitalization time between the Stenting-particle group and the bile intestinal drainage group(t = 2.314,-3.838,P <0.05),and there was no significant difference in hospitalization cost(t =-2.013,P = 0.059);There were significant differences in survival time 、 hospitalization time and hospitalization cost between the Stenting-particle group and the R1 surgery group(t=2.156、-4.246、-4.676,P<0.05);There were significant differences in hospitalization time and hospitalization cost between the Stenting-particle group and the R1 surgery group(t=-3.977 、-5.367,P<0.01),and there was no significant difference in survival time(t=0.114,P=0.91).Conclusion For patients with cholangiocarcinoma who do not undergo radical surgery,percutaneous biliary stent placement combined with 125 I seed brachytherapy can effectively reduce the jaundice,improve the liver function,Shorten the average length of hospital stay and reduce the average cost of hospitalization.Compared with palliative surgery,it is a minimally invasive,easy,safe,and effective method of operation,especially for older patients with poor physical condition.percutaneous biliary stent placement combined with 125 I seed brachytherapy is expected to become the preferred treatment of palliative surgery for cholangiocarcinoma.