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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 To investigate the efficacy of combined duodenoscopic biliary stent or nasobiliary placement with γ knife in the treatment of advanced pancreatic cancer. Methods Twenty-five patients with advanced pancreatic cancer were treated. Plastic scaffolds were placed in 26 patients and nasobiliary ducts were placed in 6 patients. Gamma knife treatment was performed 10 to 12 times per treatment and the total dose was 40 to 50 Gy. Results The success rate of intubation was 91.4%, complication in 3 cases, complication rate in 9.4%, 2 cases of acute pancreatitis and 1 case of acute cholangitis. Serum bilirubin decreased from 310 μmol / L to 126 μmol / L one week after surgery. Three months after treatment, 6 months survival rate was 96% and 80%. Conclusion Endoscopic biliary stent placement or placement of nasal bile duct combined with γ knife in the treatment of advanced pancreatic cancer is a safe and effective method.