The clinical effect evaluation of 125I seed-strip stent implantation combined with transcatheter arterial chemoembolization for malignant obstructive jaundice

Abstract

Objective: To evaluate the clinical effect of 125I seed-strip stent implantation combined with transcatheter arterial chemoembolization in the treatment of malignant obstructive jaundice. Methods: The clinical data of 120 cases with advanced malignant biliary obstructive jaundice, who lost the surgery chance or did not want to surgery in hospital, were randomly divided into three groups: biliary stent group (group A, n=40) , 125I biliary stent group (group B, n=40) and 125I biliary stent combined with transcatheter arterial chemoembolization group (group C, n=40) . The changes of total bilirubin (TBIL) , direct bilirubin (DBIL) and alkaline phosphatase (ALB) levels were observed and analyzed, and the mean biliary patency time and the survival time among three groups were evaluated. Results: Among three groups, the levels of TBIL, DBIL and ALB after 1 or 4 weeks were lower than before, the difference was statistically significant (P<0.01) . In group C, the mean biliary patency time and survival time were longer than those in groups A and B (P<0.05) . The mean survival time of groups A, B and C was (4.3±0.4) months, (5.9±0.6) months and (9.4±0.8) months, respectively, and the difference was statistically significant (F=6.897, P< 0.01) . The median survival time of group C was 14.6 months, which was significantly longer than that of groups A and B (6.1 and 9.8 months) , and the difference was statistically significant (Log-rank χ2=47.211, P< 0.05) . Conclusions: A combination of 125I biliary stent and transcatheter arterial chemoembolization can reduce jaundice, prolong the patency time of stent, and accordingly improve the quality of life of the patient after operation. Key words: Malignant obstructive jaundice; Arterial chemoemblization; 125I seed-strip; Biliary stent