经内镜胆管支架或鼻胆管置放结合γ刀治疗晚期胰腺癌的临床观察

Clinical Observation of Advanced Pancreatic Carcinoma Treated by Endoscopic Biliary Stents or Naso-biliary Tube Placement Combined with Gamma-knife Radial Therapy

目的探讨经十二指肠镜胆管支架或鼻胆管置放与γ刀结合治疗晚期胰腺癌的疗效。方法有35例晚期胰腺癌病人接受治疗,其中26例被放置塑料支架,6例放置鼻胆管,均行γ刀治疗10～12次/疗程,总剂量为40～50Gy。结果插管成功率91.4%,并发症3例,并发症发生率9.4%,2例急性胰腺炎,1例急性胆管炎。血清胆红素由310μmol/L下降到术后1周的126μmol/L。治疗后3个月、6个月存活率分别达96%及80%。结论经内镜胆管支架置放或鼻胆管置放结合γ刀治疗晚期胰腺癌是安全、有效的方法。

Objective Explore the treatment experience in advanced pancreatic carcinoma managed by endoscopic biliary stents or naso-biliary tube placement combined with gamma-knife radial therapy. Methods 35 patients suffering from advanced pancreatic carcinoma were treated, 26 patients were placed with plastic stents and 6 patients were placed with naso-biliary tubes. All patients received gamma-knife radial therapy, 10 - 12 times during the period of treatment,40 -50 Gy in general dosage. Results The intubation was successful in 91.4% patients,complication occurred in 3 patients （the rate was 9. 4% ）, including 2 acute pancreatitis and 1 acute cholangitis, serum bilirubin of postoperation decreased from 310 μmol/L to 126 μmol/L in 1 week. Survival rate after treatment was 96% and 80% in 3 months and 6 months, respectively. Conclusion Treatment of advanced pancreatic carcinoma by endoscopic biliary stents or naso-biliary tube placemnet combined with gamma-knife radical therapy is safe and effective.