Difference Of Curative Effect Between Single Biliary Stent And Biliary Stent Combined With ¹²⁵I Seed In The Treatment Of Malignant Obstructive Jaundice

Objective:To explore the difference of curative effect between single biliary stent and biliary stent combined with 125I seed in the treatment of malignant obstructive jaundice(MOJ).Materials and method:Totally 65 patients(male 37,female 28,average age 48.7)with MOJ treated with biliary stent implantation in our institution were collected between April 2015 to December 2017.All patients undergo percutaneous transhepatic cholangial drainage successfully,and were divided into observation group and control group according to whether combining with 125I seed implantation or not.Operative successful rate,serum bilirubin,T lymphocytes subset distribution,stent patency,and survival rate between the two groups were compared.Result:All operations in the two groups were successful,with operative successful rate 100%,and without serious procedure-related complications such as bleeding,peritonitis,biliary fistula,radiation enteritis,stent and seed shifting,and so on.After the operation,xanthochromia and pruritus in all patients eased gradually,and stool color was yellowing.Total bilirubin(TBIL)and direct bilirubin(DBIL)at all time points in the two groups were decreased compare with those before operation(P<0.05).At time points of before operation,1 week after operation,and 1 month after operation,differences of TBIL and DBIL between the two groups were not statistically significant(P>0.05);At 3 months after operation,TBIL and DBIL in the control group were higher than those in the observation group(P<0.05).In the observation group,the CD4 and CD4/CD8 at 1 week after operation were higher than those before operation(P<0.05).At 1 week after operation,the CD4 and CD4/CD8 in the observation group were higher than those in the control group(P<0.05).At time points of 1 month and 3 months after operation,differences of biliary stent patency between the two groups was not statistically significant(P>0.05).Biliary stent patency in the observation group at 6 months after operation were higher than that in the control group(P<0.05).Postoperative follow-up time was range 49 d to 399 d.The median survivals for the control group and observation group were 166 d(95%CI 138.0?194.0)and 250 d(95%CI 178.6?321.4),respectively,and the difference was statistically significant(?2=8.067,P=0.005).Conclusion:Biliary stent combined with 125I seed in the treatment of malignant obstructive jaundice is safe and feasible,and better than single biliary stent in decreasing bilirubin,improving cellular immune function,maintaining biliary stent patency,and prolonging lifetime,and worthy of clinical promotion.