Design And Clinical Application Of New Biliary Drainage Tube

Part IThe comparative study on improving external biliary drainage tube andtraditional external biliary drainage tube for malignant hilar biliary obstructionObjective To investigate feasibility and clinical application of the improved externalbiliary drainage tube.Methods120cases of malignant hilar biliary obstruction were randomly divided intothe improved external biliary drainage canal treatment group,60patients （theexperimental group）, and traditional biliary drainage canal treatment group,60patients （the control group）. According to the different placements of drainage tube,the lengths of the guide-wire in the biliary were measured.The patients in theexperimental group received these biliary external biliary drainage tubes weremodified by adding side-holes pursuant to the measured lengths.The patients in thecontrol group used the traditional external biliary drainage tube.The clinical efficacyof the two groups of patients was observed.Results The drainage lengths were measured in all120cases.The data is as follows:the right approach to the left bile duct branches of the measured length （65.16±12.28mm）,the right posterior branch of the right anterior to the measured length（56.00±10.30mm）, the left into the road to the right bile duct branches of themeasured length （70.74±24.24mm）.Post-operative treatment, total bilirubin anddirect bilirubin declined compared with preoperative, but the total bilirubin and thedirect bilirub of the experimental group were converse changed than the control group（p <0.05）, clinical symptoms were improved.Conclusion The improved biliary drainage tube is much more effective than thetraditional external biliary drainage tube in the treatment of malignant hilar biliary obstruction. The use of The improved biliary drainage tube in PTCD is a simple，effective and cost-effective biliary decompression method. Part IIClinical efficacy of biliary stent combined with linear¹²⁵I radioactive particlesfor the treatment of malignant obstructive jaundiceObjective Explore the feasibility and clinical effect of biliary stent combined withLinear¹²⁵I radioactive particles for the treatment of malignant obstructive jaundice.Methods The patients whose continuous treatment since October2010, clinicaldiagnosis （or pathological examination） demonstrated malignant obstructive jaundice,transhepatic cholangiography feasible stent implantation,non-organ dysfunction,non-multiple metastasis and life expectancy more than3months included in the study.40patients were included in the study，and randomly divided into two groups（theexperimental group and the control group） with20patients each. Control grouppatients are conventionally biliary stand draining, the experimental group patients onthe basis of stent implantation, implant linear¹²⁵I radioactive particles into thestrictures of biliary for intraluminal brachytherapy. Postoperative follow upto April15,2013. The patients were observable for clearance of jaundice, stent patency,survival and complications after operation.Results All patients had successful surgery, no surgery-related deaths. The bilirubinafter3months and6months of surgery of experimental group compared with those ofthe control group was not obvious difference in the same period （P>0.05）, indicatedthat the experimental group with the control group in terms of biliary drainage nodifference; the difference of liver function of experimental group after3monthscompared with preoperative was significantly obvious （P<0.05）, while there was nosignificant difference in the WBC（P>0.05）, showed that the¹²⁵I particles on liverfunction, hematopoietic system were not significant inhibitory effects; the stentpatency rate of experimental group at3months,6months after operation compared with the control group was significantly obvious （P<0.05, P<0.001）, played a distinctrole on inhibiting the biliary disease progression; the median survival of theexperimental group was45weeks, while that of the control group was40weeks （x2=0.033,P<0.05）], showed¹²⁵I particles was a statistically significant difference onextending the survival time of patients between the two groups; experimental grouppatients had2cases of biliary tract infection,3cases of bacteremia; compared thoseof1case of biliary tract infection and2cases of bacteremia in the control group （x2=0,P>0.05）, the linear radioactive particles will not increase the incidence ofpostoperative complications.Conclusion Biliary stent combined with linear¹²⁵I radioactive particles for thetreatment of malignant obstructive jaundice was convenient and feasible,comparedonly stand draining. It can increase stent patency rate and extend patients’ survival onthe bases of incidence of postoperative complications without addition, the biliarydrainage and the liver function and hematopoietic systems does not affect.