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ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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3/2020
vol. 12
 
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abstract:
Original paper

The efficacy of the combination of percutaneous transhepatic biliary drainage and 125I stranded seeds for malignant bile duct obstruction treatment

Shuangxi Li
1
,
Baohua Li
1
,
Lei Li
1
,
Xujun Yang
1
,
Fangyu Xu
,
Wenhui Wang

1.
Interventional Department, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
J Contemp Brachytherapy 2020; 12, 3: 225–232
Online publish date: 2020/06/30
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Introduction
To investigate the efficacy of percutaneous transhepatic biliary drainage (PTBD) combined with iodine-125 (125I) stranded seeds for the treatment of malignant bile duct obstruction (MBO).

Material and methods
A retrospective study was performed on 58 consecutive MBO patients. Twenty patients underwent PTBD combined with 125I stranded seeds (group A). Thirty-eight patients underwent percutaneous trans-hepatic biliary drainage (group B). Total bilirubin, direct bilirubin, and indirect bilirubin levels were compared preoperatively, 1-week, 1-month, and 3-months post-operatively. Carbohydrate antigen 19-9 (CA19-9), cancer antigen 125 (CA125), and carcino-embryonic antigen (CEA) levels were compared at preoperative and 3-month post-operative stages. The time free from biliary obstruction and survival times were compared.

Results
The differences in total bilirubin, direct bilirubin, and indirect bilirubin levels between the two groups were not significant preoperatively (p = 0.857, p = 0.719, and p = 0.870), and 1-week post-operatively (p = 0.259, p = 0.395, and p = 0.145). However, 1-month (p = 0.012, p = 0.005, and p = 0.049) and 3-months post-operatively (p < 0.001, p = 0.001, and p = 0.001), group A was lower than group B. Differences in CA19-9, CA125, and CEA levels between the two groups were not significant preoperatively (p = 0.229, p = 0.116, and p = 0.273) and 3-months post-operatively (p = 0.159, p = 0.342, and p = 0.306). The median biliary obstruction free time was 7.0 months for group A and 5.0 months for group B (p < 0.001). The median survival time was 9.0 months for group A and 6.0 months for group B (p = 0.001).

Conclusions
PTBD combined with 125I stranded seeds seem to reduce bilirubin levels and prevents biliary obstruction, promoting survival.

keywords:

percutaneous transhepatic biliary drainage, iodine-125, malignant bile duct obstruction, survival

 
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