| Background Biliary stent implantation has already become one of the alleviative treatment of the malignant obstructive jaundice, which will effect the therapeutic efficacy, because the stent will become restenosis in some patients after the 3-6months in the clinical practice observation. People have ever tried to use biliary tract intracavitary therapy after the biliary stent implantation, but the curative effects were not obvious because of the limit of the radiotherapy methods and radiation source, such as short exposure time and carrying the drainage tube. 1-125 seeds which were made in China recently has the characteristic of low dose rate and persistent irradiation, which can redeem the insufficiency of the irradiation and be the permanent radiation source. It is hope to decrease the restenosis of the stent by applying the 1-125 seeds in the bile duct. There were no reports about it. Purpose To evaluate the effect to the different syndromes of jaundice by biliary stent implantation -fintraluminal brachytherapy by 1-125 seeds. Try to settle the problem of restenosis and obstruction.Method The patients in hospital 9th , 2003-2nd, 2006. Male thirteen and female eleven, the average is 69.5 year-old(40-91year-old).All of them have the obvious jaundice, which the totle bilirubin is 321. 7μmol/L and the direct bilirubin is 204. 5μmol/L. We put the 24 cases into two groups yin-yellow and yang-yellow by differentiation, which are put into treatment group (biliary stent implantation + intraluminal brachytherapy by 1-125 seeds) and antitheses group (biliary stent implantation). All the patients will be followed 3 months and check-up the totle bilirubin, the direct bilirubin, the position of the stent and the seeds. We hope to evaluate the effect to the restenosis and obstruction of the stent in the malignant obstructive jaundice patients by 1-125 seeds. And to valuate the effect of the different syndrome of the jaundice by biliary stent implantation +intraluminal brachytherapy.by 1-125 seeds.Result The 26 cases were implanted into biliary stent, ten of which were implanted into 1-125 seeds. In the 3-month follow-up, two of them were implanted biliary stent died from failure of the respiratory and circulation system in the advanced stage of tumor, who were screen out. Two of them were implanted biliary stent+ 1-125 seeds died from failure of the respiratory and circulation system in the advanced stage of tumor without jaundice. In the stent+ 1-125 seeds group, two patients were ending theropy and the 1-125 seeds were pulled out because of the bad concrescent. According to the data of the totle bilirubin, the direct bilirubin, the white blood cell, the function of liver and kidney and the condition of the stent, there were no obviously difference. But it shows that that the curative effect of the yang-yellow stent+ 1-125 seeds group was better than the yin-yellow stent+ 1-125 seeds group by analyzsing the level of the bilirubin. And we found the stent opening rate of the 1-125 seeds group after 3 months was 100%, which was higher than the stent group. Intraluminal brachytherapy by 1-125 seeds have no obviously effect to the white blood cell and the function of liver and kidney of the patients.Conclusion The preliminary observation indicated that biliary stent implantation +intraluminal brachytherapy by 1-125 seeds in treating the malignant obstructive jaundice is a safe and effective method. More over it is a little better in treating the yang-yellow syndrome than yin-yellow syndrome.
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