Observation on the effect of CT-guided thermal ablation combined with metal stent implantation in the treatment of unresectable cholangiocarcinoma patients

Abstract

Abstract: Objective This study aimed to evaluate the therapeutic effect of combining percutaneous CT-guided thermal ablation with biliary metal stent placement for patients with non-operable cholangiocarcinoma. Methods From March 2017 to December 2021, 106 patients in the 904th Hospital of the Joint Service Support Force of the Chinese People′s Liberation Army with unresectable cholangiocarcinoma were involved and randomly divided into control group (metal stent implantation) and observation group (radiofrequency ablation+metal stent implantation), with 53 cases in each group. The operation conditions of the two groups were compared, and serum levels of aspartate aminotransferase (AST), total bilirubin (TBil) and other indicators were measured. The incidence of complications, biliary tract patency time, survival time and survival rate of the two groups were recorded, and the survival curve was made. Results The operative time in the observation group was (98.2 ± 13.7) min, which was longer than that in the control group (49.6 ± 5.8) min, with a statistically significant difference (P< 0.05). After treatment, the serum levels of TBil, AST, alanine aminotransferase (ALT), alkaline phosphatase (ALP), and gamma-glutamyl transpeptidase (γ-GT) in the observation group were (48.7±12.6) μmol/L, (33.5±6.8) U/L, (54.7±11.4) U/L, (226.3±37.8) U/L, and (241.7±36.2) U/L, respectively, significantly lower than those in the control group: (91.6±20.5) μmol/L, (57.8±14.2) U/L, (72.5±9.3) U/L, (285.6±53.9) U/L, and (342.8±49.5) U/L, with statistically significant differences (P<0.05). The complication rates in the observation group and the control group were 26.4% and 20.8%, respectively, showing no significant difference (P>0.05). After 18 months of follow-up, the biliary patency duration, survival time, and 18-month survival rate in the observation group were (8.7±1.4) months, (13.6±1.9) months, and 52.8%, respectively, which were significantly higher than those in the control group: (5.9±1.1) months, (9.7±1.4) months, and 32.1% (P<0.05). Conclusion The combination of CT-guided thermal ablation and metal stent implantation is effective in the treatment of patients with unresectable cholangiocarcinoma, which is conducive to improving the liver function, prolonging the biliary patency duration and survival time of stents and improving the survival rate of patients within 18 months, but the incidence of postoperative complications has not been significantly improved.

Key words: Cholangiocarcinoma, Inoperable, Radio frequency ablation, Stand, Survival curve

LANG Wei-wei, LU Ze-hua, GENG Cheng-jun. Observation on the effect of CT-guided thermal ablation combined with metal stent implantation in the treatment of unresectable cholangiocarcinoma patients[J]. Chinese Hepatolgy, 2026, 31(4): 521-524.

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