Abstract:

Objective  To investigate the difference of clinical therapeutic effect between percutaneous transhepatic cholangial drainage (PTCD) by biliary stent and biliary stent combined with 125I seed implantation for the treatment of patients with malignant obstructive jaundice. Methods  A total of 62 patients with malignant obstructive jaundice were randomly divided into the control group (n=31) and treatment group (n=31) after undergoing PTCD. Patients of the control group underwent biliary stent implantation and those of the treatment group underwent biliary stent combined with 125I seed implantation. The subsidence of jaundice, tumor recurrence, level of serum tumor marker CA199, and survival time of two groups before and after treatment were compared. Results  Operations of all patients were successful. The differences of the level of serum total bilirubin between two groups before PTCD and 1 week after stent implantation were not statistically significant (P>0.05). The levels of serum total bilirubin of the treatment group 1 and 3 months after operation were significantly lower than those of the control group (P<0.05). Three patients of the treatment group and 14 patients of the control group suffered the biliary obstruction recurrence during the follow-up period (P>0.05). The level of serum tumor marker CA199 of the treatment group 1 or 2 weeks after operation was significantly lower than that before operation (P<0.05). The median survival time of the treatment group and control group was 11 and 7 months and the difference was statistically significant (P<0.05). Conclusion  Compared with treatment of PTCD by biliary stent, the combination of biliary stent and 125I seed implantation is better in terms of subsidence of jaundice, inhibition of tumor growth, and increase of survival time and is hopeful for clinical applications.

Key words: percutaneous transhepatic cholangial drainage, malignant obstructive jaundice, biliary stent, 125I seed