目的：报道胆道恶性肿瘤晚期病人应用免疫检查点抑制剂致相关性肺炎（CIP）的病例，以期提供更多该疾病评估、治疗和监测的处理方法。方法：3例病人在化疗联合免疫治疗过程中，出现氧饱合度降低、肺间质病变。联合呼吸科诊断为CIP。急性期停止抗肿瘤治疗，并予糖皮质激素等治疗，定期监测病情变化。随访中，病例1肺转移；病例2好转；病例3合并感染且肿瘤进展。结果：糖皮质激素改善CIP病人的肺部病变及缺氧症状，但要关注合并其他感染及肿瘤进展的可能。结论：对于胆道晚期肿瘤病人，综合评估并早期识别CIP是非常重要的，尤其对应用糖皮质激素后病情反复的病人，要及时并精准调整治疗方案。

Objective To report cases of checkpoint inhibitor pneumonitis （CIP） in patients with advanced biliary tract cancer, aiming to provide additional approaches for the assessment, treatment, and monitoring of this condition. Methods Three patients developed oxygen desaturation and interstitial lung lesions during chemotherapy combined with immunotherapy, and were diagnosed with CIP in collaboration with the respiratory department. Antitumor therapy was discontinued in the acute phase, and glucocorticoids were administered, with regular monitoring of disease progression. During follow-up, case 1 developed lung metastasis; case 2 showed improvement; case 3 had concurrent infection and tumor progression. Results Glucocorticoids improved lung lesions and hypoxic symptoms in patients with CIP, but attention should be paid to the potential for concurrent infections and tumor progression. Conclusions Comprehensive assessment and early identification of CIP are crucial for patients with advanced biliary tract cancer. For those with recurrent symptoms after glucocorticoid therapy, timely and accurate adjustment of the treatment regimen is essential.