eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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6/2022
vol. 14
 
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abstract:
Original paper

Factors related to stent patency and early elimination of jaundice using bile duct stent combined with iodine-125 seed implantation in malignant obstructive jaundice

Lian-Qiang Han
1, 2, 3
,
Nian-Jun Xiao
2, 3
,
Fang Liu
3
,
Xiang-Dong Wang
3
,
Zi-Kai Wang
3
,
Wen Li
1, 2, 3

1.
School of Medicine, Nankai University, Tianjin, China
2.
Medical School of Chinese People’s Liberation Army (PLA), Beijing, China
3.
Department of Gastroenterology and Hepatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
J Contemp Brachytherapy 2022; 14, 6: 542–550
Online publish date: 2022/12/30
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Purpose
Biliary stents combined with percutaneous or endoscopic ultrasound-guided iodine-125 seed implantation into primary tumor have been confirmed to relieve malignant obstructive jaundice (MOJ), and prolong patient’s stent patency. The aim of the study was to evaluate meaningful clinical application indications and better guide the application of this technology.

Material and methods
Patients with MOJ, who have received bile duct stenting combined with iodine-125 (125I) seed implantation from October, 2010 to April, 2022, were retrospectively analyzed. Univariate and multivariate analyses were adopted to indicate factors of stent patency in MOJ and influencing factors of jaundice reduction at one week after surgery.

Results
A total of 90 patients were enrolled into the study, including 52 males (57.8%) and 38 females (42.2%), with a mean age of 68.66 ±12.53 years. The median stent patency was 8 months. No serious adverse events occurred during follow-up. Multivariate analysis showed that Child-Pugh score (HR = 2.221, 95% CI: 1.081-4.562), biliary infection (HR = 1.901, 95% CI: 1.084-3.335), and pre-operative jaundice duration (HR = 1.977, 95% CI: 1.106-3.533) were the independent risk factors for stent patency. Child-Pugh B/C (OR = 4.647, 95% CI: 1.080-19.982) and bile duct infection (OR = 3.583, 95% CI: 1.095-11.725) were the independent risk factors for jaundice reduction at one week after surgery.

Conclusions
MOJ patients treated with biliary stents combined with 125I seed implantation, and patients with better pre-operative liver function and no biliary tract infection, present not only longer biliary stent patency, but also better early jaundice reduction.

keywords:

malignant obstructive jaundice, iodine-125 seed, stent patency

 
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