探讨¹²⁵I粒子条联合胆道支架治疗Bismuth-Corlette Ⅲ/Ⅳ型肝门部胆管癌（HCCA）的疗效。

回顾性分析2016年9月至2021年4月新疆医科大学附属第一医院采用¹²⁵I粒子条联合胆道金属支架植入治疗的20例Bismuth-Corlette Ⅲ/Ⅳ型HCCA患者临床资料。患者均签署知情同意书，符合医学伦理学规定。其中男8例，女12例；平均年龄（69±12）岁；Ⅲa型2例，Ⅳ型18例。DSA透视下经皮经肝穿刺至肝内胆管，放置胆道金属支架和¹²⁵I粒子条。观察患者手术情况及并发症发生情况。采用Kaplan-Meier法分析生存时间及支架通畅率。

20例患者均成功植入胆道金属支架及¹²⁵I粒子条，手术成功率100%。共植入胆道金属支架40枚和¹²⁵I放射性粒子417枚。术后寒战、高热及疼痛2例，胆道感染1例，未出现胆道穿孔、出血等并发症。随访时间2~28个月，中位时间12个月。支架中位通畅时间382 d，术后3、6、12个月累积支架通畅率分别为95.0%、86.4%、59.2%。患者中位生存时间353 d，术后3、6、12个月累积生存率分别为89.2%、75.3%和45.2%。

¹²⁵I粒子条联合胆道支架是治疗Bismuth-Corlette Ⅲ/Ⅳ型HCCA的一种安全有效方法，能提高支架通畅时间及延长生存期，且不增加并发症发生率。

To evaluate the clinical efficacy of ¹²⁵I seed strip combined with biliary stent in the treatment of Bismuth-Corlette type Ⅲ/Ⅳ hilar cholangiocarcinoma (HCCA).

Clinical data of 20 patients with Bismuth-Corlette type Ⅲ/Ⅳ HCCA treated with ¹²⁵I seed strip combined with biliary metallic stent implantation in the First Affiliated Hospital of Xinjiang Medical University from September 2016 to April 2021 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 8 patients were male and 12 female, aged (69±12) years on average, 2 cases of type Ⅲa and 18 type Ⅳ HCCA. Biliary metallic stent and ¹²⁵I seed strip were implanted into the intrahepatic bile duct via percutaneous transhepatic puncture under digital subtraction angiography. Surgical conditions and postoperative complications were observed. The survival time and stent patency rate were analyzed by Kaplan-Meier method.

biliary metal stents and ¹²⁵I seed strips were successfully implanted in 20 patients, with a surgical success rate of 100%. 40 biliary metal stents and 417 ¹²⁵I radioactive seeds were implanted. Postoperatively, 2 patients suffered from chill, high fever and pain, and 1 case developed biliary tract infection. No postoperative complications, such as biliary perforation and bleeding, occurred. All patients received postoperative follow-up for 2 to 28 months, with a median of12 months. The median stent patency time was 382 d. The 3-, 6- and 12-month cumulative stent patency rates were 95.0%, 86.4% and 59.2%, respectively. The median survival time of all patients was 353 d. The 3-, 6- and 12-month cumulative survival rates were 89.2%, 75.3% and 45.2%, respectively.

¹²⁵I seed strip combined with biliary stent is a safe and efficacious treatment for Bismuth-Corlette type Ⅲ/Ⅳ HCCA, which can prolong the stent patency time and survival time without increasing the incidence of postoperative complications.