Gao Fu-Lei, Wang Yong, Lu Jian, Zhu Guang-Yu, Huang Xiang-Zhong, Ren Dong-Qing, Guo Jin-He
Nanjing Medical University, Nanjing, China.
Department of Interventional Radiology, Affiliated Jiangyin Hospital of Medical College of Southeast University, Jiangyin, China.
Wideochir Inne Tech Maloinwazyjne. 2021 Dec;16(4):678-685. doi: 10.5114/wiitm.2021.105530. Epub 2021 Apr 20.
Stent insertion is the most frequently used option to treat malignant biliary obstruction (MBO) patients. Hilar cholangiocarcinoma (HCCA) is the most common disease that causes hilar MBO.
To assess the clinical efficacy and long-term outcomes of I-125 seed-loaded stent (ISS) insertion for HCCA patients.
Consecutive patients with HCCA underwent either normal stent (NS) or ISS insertion between January 2017 and December 2019. The baseline and treatment data of these two groups were compared.
During the period, a total of 93 patients with inoperable HCCA were divided into either NS (n = 48) or ISS (n = 45) insertion groups at our centre. Technical success rates of the NS and ISS insertion were 91.7% and 95.6%, respectively (p = 0.733). Clinical success rates were 93.2% and 100% in the NS and ISS groups, respectively (p = 0.24). Stent dysfunction was observed in 11 and 8 patients in the NS and ISS groups, respectively (p = 0.47). The median stent patency was 143 days and 208 days in the NS and ISS groups, respectively (p < 0.001). All patients died in the follow-up period, with median survival duration of 178 days and 220 days in the NS and ISS groups, respectively (p < 0.001). ISS insertion was the only predictor of longer patency (p = 0.002) and survival (p = 0.01).
ISS insertion might achieve longer patency and overall survival in patients with inoperable HCCA as compared with NS insertion.
支架置入是治疗恶性胆管梗阻（MBO）患者最常用的方法。肝门部胆管癌（HCCA）是导致肝门部MBO的最常见疾病。
评估I-125粒子支架（ISS）置入治疗HCCA患者的临床疗效和长期预后。
2017年1月至2019年12月期间，连续纳入的HCCA患者接受了普通支架（NS）或ISS置入。比较两组的基线和治疗数据。
在此期间，本中心共有93例无法手术切除的HCCA患者被分为NS置入组（n = 48）和ISS置入组（n = 45）。NS和ISS置入的技术成功率分别为91.7%和95.6%（p = 0.733）。NS组和ISS组的临床成功率分别为93.2%和100%（p = 0.24）。NS组和ISS组分别有11例和8例患者出现支架功能障碍（p = 0.47）。NS组和ISS组的支架中位通畅时间分别为143天和208天（p < 0.001）。所有患者在随访期间均死亡，NS组和ISS组的中位生存时间分别为178天和220天（p < 0.001）。ISS置入是支架更长通畅时间（p = 0.002）和生存时间（p = 0.01）的唯一预测因素。
与NS置入相比，ISS置入可能使无法手术切除的HCCA患者获得更长的支架通畅时间和总生存期。
