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Biliary self-expandable metallic stent combined with iodine-125 seeds in the treatment of malignant biliary obstruction (Bismuth type I or II)

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Abstract

Background

The purpose of this research was to evaluate the safety and efficacy of a self-expandable metallic stent (SEMS) combined with iodine-125 (125I) seeds in the treatment of Bismuth type I or II malignant biliary obstruction (MBO).

Methods

The clinical data of 74 cases of MBO treated with percutaneous SEMS combined with 125I seeds (combination group) and 81 cases of MBO treated with SEMS implantation alone (control group) in our hospital from January 2015 to December 2019 were retrospectively analyzed. The short-term and long-term efficacy of the two groups were compared. Multivariate Cox regression analysis was used to analyze the factors affecting the surgical efficacy and survival rate.

Results

The liver blood test results of both groups improved at one week and one month post-stent insertion. No significant difference was established in the short-term efficacy or complications between the two groups (P = NS). Improved stent patency was observed in the combined group, 9.01 ± 4.38 months versus 6.79 ± 3.13 months, respectively (P < 0.001). Improved survival was also noted in the combined group 12.08 ± 5.38 months and 9.10 ± 4.16 months, respectively (P < 0.001). Univariate and multivariate analyses showed that the type of biliary stent and liver metastasis were independent factors affecting survival.

Conclusion

The implementation of SEMS combined with 125I seeds resulted in significantly longer stent patency and survival times than that of SEMS implantation alone, which is thus worthy of clinical promotion and application.

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Acknowledgements

This study was supported by a grant from the Scientific Research Program for Department of Education of Anhui Province (No. 2022AH040192).

Funding

Funding was provided by Scientific Research Foundation of Education Department of Anhui Province of China (No. 2022AH040192).

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Author notes

  1. Jie Chai and Kaicai Liu have contributed equally to this work.

Authors and Affiliations

  1. Department of Interventional Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, 17 Lujiang Road, Hefei, 230001, Anhui, China

    Jie Chai, Beibei Xu, Lijun Wang, Huafeng Yu, Weifu Lv & Dong Lu

  2. Infection Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230022, Anhui, China

    Kaicai Liu

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  1. Jie Chai
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Correspondence to Dong Lu.

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Jie Chai, Kaicai Liu, Beibei Xu, Lijun Wang, Huafeng Yu, Weifu Lv and Dong Lu have no conflict of interest or financial ties to disclose.

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Chai, J., Liu, K., Xu, B. et al. Biliary self-expandable metallic stent combined with iodine-125 seeds in the treatment of malignant biliary obstruction (Bismuth type I or II). Surg Endosc 37, 7729–7737 (2023). https://doi.org/10.1007/s00464-023-10327-z

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  • DOI: https://doi.org/10.1007/s00464-023-10327-z

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