PTCD Combined With Gamma Knife For Management Of Malignant Obstruction Of Biliary Tract

Objective To evaluate the effect of PTCD(include metallic stent placement)combined with Gamma knife for management of malignant obstruction of biliary tract.Methods 77 patients with malignant obstructive were analysed,including 22 treat with PTCD combined with Gamma knife and 30 with Gamma alone and 25 with PTCD alone.The effects of turner therapy,regression of jaundice(TB,DB),patency time of drainge-tube,hepatic function(ALT,AST),kidney function(Bun,Cr),pain relief rate,side effects,survival time were observed.Results Combined therapy group's response rate(CR+PR)was 81.8%,complete remission(CR)5cases,partial remission(PR)13 cases,PD 4 cases.Gamma kinife group's response rate was 73.3%,CR 6 cases,PR 16 cases.PTCD group's PD cases was 25. Combined therapy group and PTCD group jaundice regression rate was 100%in one week after treatment,gamma knife group's jaundice regression rate was 66.7% respectively;afert two weeks of treatment,combined therapy group,PTCD group,gamma group's jaundice regression rate was 100%,100%,60%respectively; alert three months of treatment,combined therapy group,PTCD group,gamma group's jaundice regression rate was 90.9%,84%,50%respectively;afert six months of treatment,combined therapy group,PTCD group,gamma group's jaundice regression rate was 81.8%,80%,0%respectively.The survival time of combined therapy group,PYCD group,gamma group was 12.3±3.5 months,11.4±2.5 months,5.5±2.1 months respectively,give a significant difference between combined group and PTCD group,gamma group and PTCD group(P＜0.05).Conelusion PTCD combined with Gamma knife is more effective to the PTCD alone and Gamma alone.