Effect of biliary stent implantation combined with intrabile duct perfusion chemotherapy in the treatment of advanced extrahepatic cholangiocarcinoma

ObjectiveTo explore the effects of biliary stent implantation combined with intrabile duct perfusion chemotherapy in the treatment of advanced extrahepatic cholangiocarcinoma(EHCC).

MethodsThe clinical data of 86 advanced EHCC patients treated with percutaneous extrahepatic biliary stenting(PTBS group) or PTBS combined with intraductal perfusion chemotherapy(PTBS combined with intraductal perfusion chemotherapy group) were retrospectively analyzed.The improvement of liver function, complications and postoperative survival were analyzed.The influencing factors of overall survival(OS) were analyzed using Kaplan-Meier curve and Cox regression model.

ResultsCompared with before operation, the serum levels of ALT, AST and TBIL significantly reduced after 1, 3 and 6 months of operation(P < 0.05), the decreasing degree of which in PTBS combined with intraductal perfusion chemotherapy group was more obviously than that in PTBS group, and the increasing degree of ALB level in PTBS combined with intraductal perfusion chemotherapy group was more obviously than that in PTBS group.The difference of the incidence rate of postoperative complication between two groups was not statistically significant(P>0.05).The median survival time and 1-year survival rate in PTBS group were 7 months and 11.3%, respectively.The median survival time and 1-year survival rate in PTBS combined with intraductal perfusion chemotherapy group were 10 months and 37.5%, respectively.Log-rank test suggested that the PTBS combined with intraductal perfusion chemotherapy could improve the prognosis, and prolong the survival of EHCC patients.Cox regression analysis showed that the PTBS combined with intraductal perfusion chemotherapy was an independent protective factor for prognosis(HR=0.46, 95%CI:0.23-0.92, P < 0.05).

ConclusionsCompared with the simple PTBS, the PTBS combined with intraductal perfusion chemotherapy can improve the prognosis, and prolong the survival of EHCC patients.The PTBS combined with intraductal perfusion chemotherapy has good treatment effect, which is worthy of further clinical exploration and research.