The Clinical Study Between Percutaneous Approach And Laparotomy Way Of Implanted¹²⁵I Particles Guided By Ultrasound In The Treatment Of Pancreatic Cancer

Objective:To compare ultrasound guided percutaneous puncture andultrasound guided by laparotomy implanted radioactive125I seeds twoways clinical effect and feasibility for the treatment of locally advancedpancreatic cancer.Methods:Forty Patients with pancreatic cancer unable to surgical resectionWere divided into2groups at random. Group A application ultrasoundguided percutaneous puncture implantation radioactive particle125I. Theassociated with obstructive jaundice patients within the firstpercutaneous biliary stenting. Affter jaundice symptoms turn for thebetter ultrasound guided percutaneous puncture implantation radioactiveparticle125I.Group B application open surgical exploration, according tothe operation and symptoms seen in the selective biliary intestinalanastomosis, gastrointestinal anastomosis operation, after operation tocomplete and intraoperative ultrasound guided to implantate radioactiveI125particle. Intraoperative ultrasound guided real-time observation oftumor and its surrounding structures, to choose the best puncture path, adjust the direction of the probe and the needle Angle from the bile duct,pancreatic duct and visible blood vessels, according to the preoperativeTPS embedded particles. By way of percutaneous puncture extrabreathing, probe pressure adjustment and piercing through thegastrointestinal tract wall when necessary. Review of ultrasound beforeout of the hospital, confirm whether there is a delayed hemorrhage orbile pancreatic fistula. Postoperative3months review of ultrasound andCT, To observe the target tumor size. Postoperative4-36monthsfollow-up record patient surial.Results:All patients are one-time smoothly implanted, neither biliary fistula、pancreatic fistula、 abdominal cavity hemorrhage、perforation of thegastrointestinal complications. A group of2cases of postoperative fever,symptomatic treatment after improving. Group B in5cases ofpostoperative fever,2cases had the calf muscle between enousthromboembolism, improvement after thrombolytic therapy;1caseappeared early postoperative intestinal obstruction, after symptomatictreatment better.Group A preoperative abdominal pain16cases,13casesof complete response, partial response in2cases,1had no effect. GroupB preoperative abdominal pain15cases,10cases of complete response,partial response in3cases,2cases failed response. After3monthsfollow-up of tumor size, group A CR3cases, PR14cases, SD3 cases,efficient (CR+PR)/ALL was85.0%;Group B CR2cases,PR14cases, SD4cases, efficient (CR+PR)/ALL was80.0%. Betweenthe two groups (P>0.05). A group of patients survival11.15±3.45months on average, Group B patients survival11.40±6.98months onaverage. Between the two groups (P>0.05).Conclusions：1. The implantation of radioactive125I particle surface way guidedby ultrasound treatment of locally advanced pancreatic cancer in painrelief, tumor local control and survival can achieve the same effect withopen way guided by ultrasound implanted radioactive125I particle。2. The implantation of radioactive125I particle surface way guidedby ultrasound is simple and flexible, minimally invasive operation, timesaving, and the advantages of less complications.