Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
Surg Endosc. 2022 Jul;36(7):4932-4938. doi: 10.1007/s00464-021-08848-6. Epub 2021 Nov 29.
To evaluate the efficacy and safety of brachytherapy with double-strand I seeds and biliary drainage for malignant obstructive jaundice.
42 patients with obstructive jaundice because of extrahepatic cholangiocarcinoma were enrolled. 22 patients (group A) received a biliary stent with common drainage tube implantation, and 20 patients (group B) received a biliary stent with double-strand I seeds radiotherapy drainage tube placement. The length, location and pathological stage of biliary stricture were recorded in the two groups. Total bilirubin (TBIL), direct bilirubin (DBIL), IgA, IgG, IgM, alanine aminotransferase and white blood cell (WBC) count were measured before and after percutaneous transhepatic cholangial drainage (PTCD). Tumor diameter was measured before and three months after PTCD, and the difference were calculated. Stent patency time, survival time, and complications were recorded.
There was no significant difference in the length, location and pathological stage of biliary stenosis between the two groups. There was no significant difference in TBIL, DBIL, IgA, IgG, IgM, alanine aminotransferase and WBC count between the two groups before or after PTCD (P > 0.05). Three months after PTCD, tumors growth in group A and tumors shrinkage in group B. The difference in tumor size between the two groups before and after PTCD was statistically significant (P < 0.05). The average stent patency times in groups A and B were 3.55 ± 0.76 months and 8.76 ± 1.85 months, respectively (P < 0.05). The average survival times in groups A and B were 133.5 ± 27.8 days and 252.5 ± 114.5 days, respectively (P < 0.05). There was no statistically significant difference in the incidence of complications between the two groups (P > 0.05).
Double-strand I seeds radiotherapy biliary drainage tubes can safely and effectively control tumors, prolong the patency of biliary stents, and prolong patient survival.
评价双 I 放射性粒子支架内引流治疗恶性梗阻性黄疸的疗效和安全性。
42 例因肝外胆管癌所致梗阻性黄疸患者入组。22 例患者（A 组）接受胆道支架联合普通引流管植入术，20 例患者（B 组）接受胆道支架联合双 I 放射性粒子支架内引流术。记录两组患者的胆管狭窄长度、位置和病理分期。比较两组患者经皮肝穿刺胆道引流（PTCD）前后总胆红素（TBIL）、直接胆红素（DBIL）、IgA、IgG、IgM、丙氨酸氨基转移酶和白细胞（WBC）计数的变化。测量并计算 PTCD 前后肿瘤直径的变化。记录支架通畅时间、生存时间及并发症。
两组患者胆管狭窄的长度、位置和病理分期差异无统计学意义。PTCD 前后两组患者的 TBIL、DBIL、IgA、IgG、IgM、丙氨酸氨基转移酶和 WBC 计数差异均无统计学意义（P>0.05）。PTCD 后 3 个月，A 组肿瘤增大，B 组肿瘤缩小。两组患者 PTCD 前后肿瘤大小差异有统计学意义（P<0.05）。A、B 两组支架通畅时间分别为 3.55±0.76 个月和 8.76±1.85 个月，差异有统计学意义（P<0.05）。A、B 两组患者生存时间分别为 133.5±27.8 天和 252.5±114.5 天，差异有统计学意义（P<0.05）。两组患者并发症发生率差异无统计学意义（P>0.05）。
双 I 放射性粒子支架内引流能安全、有效地控制肿瘤，延长胆道支架的通畅时间，延长患者的生存时间。
