Abstract
Aim
To evaluate the efficacy and safety of brachytherapy with double-strand 125I seeds and biliary drainage for malignant obstructive jaundice.
Methods and Materials
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 125I 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.
Results
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).
Conclusion
Double-strand 125I seeds radiotherapy biliary drainage tubes can safely and effectively control tumors, prolong the patency of biliary stents, and prolong patient survival.
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Acknowledgements
Thanks go to TuoRen Medical Group for its assistance in manufacturing a biliary drainage tube for use in this study.
Funding
Science and Technology project od Henan Province, Grant/Award Numbers: SB201902005 and SB201902014.
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Zong-Ming Li, De-Chao Jiao, Xin-Wei Han, Qin-Yu Lei, Xue-Liang Zhou and Miao Xu have no conflicts of interest or financial ties to disclose.
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We obtained permission from the Ethics Committee of the First Affiliated Hospital of Zhengzhou University.
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Li, ZM., Jiao, DC., Han, XW. et al. Preliminary application of brachytherapy with double-strand 125I seeds and biliary drainage for malignant obstructive jaundice. Surg Endosc 36, 4932–4938 (2022). https://doi.org/10.1007/s00464-021-08848-6
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DOI: https://doi.org/10.1007/s00464-021-08848-6