胆管支架联合光动力和（或）射频消融治疗在肝外胆管癌中的应用

Application of biliary stent combined with photodynamic therapy and (or) radiofrequency ablation to extrahepatic cholangiocarcinoma

摘要:

为探讨内镜下胆管支架置入后行光动力治疗（photodynamic therapy，PDT）和（或）射频消融术（radiofrequency ablation，RFA）在不可切除肝外胆管癌（extrahepatic cholangiocarcinoma，EHCC）姑息治疗中的应用，回顾性分析了2017年1月至2023年1月在青岛大学附属医院消化内科治疗的5例EHCC患者的临床资料。5例患者均先接受胆管支架置入治疗，支架置入后6个月内接受PDT和（或）RFA。5例患者手术均成功。治疗后，5例患者血清胆红素水平均明显下降，术后恢复良好，1~3 d即好转出院。1例患者出现感染性并发症，其余均未发生不良事件。胆管支架治疗先于PDT和（或）RFA对EHCC进行姑息治疗，为后续PDT和（或）RFA顺利进行创造良好条件，可明显提高手术成功率，快速有效解除管腔梗阻，减少术后不良事件的发生，缩短术后恢复时间。

Abstract:

To explore the application of photodynamic therapy (PDT) and (or) radiofrequency ablation (RFA) after endoscopic biliary stent placement in the palliative treatment of unresectable extrahepatic cholangiocarcinoma (EHCC), clinical data of 5 EHCC patients who were treated at the Department of Gastroenterology, the Affiliated Hospital of Qingdao University from January 2017 to January 2023 were analyzed. Five EHCC patients were treated with biliary stenting followed by PDT and (or) RFA within 6 months. The operation was successful in 5 patients. After treatment, the serum bilirubin levels of 5 patients significantly decreased, and they were discharged from the hospital after 1-3 days of recovery. Only 1 patient had infectious complication, while the other patients did not experience any adverse events. Biliary stenting prior to PDT and (or) RFA for palliative treatment of EHCC creates favorable conditions for subsequent PDT and (or) RFA, which can significantly improve the success rate of the operation, effectively alleviate lumen obstruction, reduce postoperative adverse events, and shorten postoperative recovery time.