| Objectives:Objective to investigate the clinical efficacy and safety of iodine-125 radioactive stent in the treatment of cholangiocarcinoma with obstructive jaundice.Methods:A retrospective analysis of 51 cases of malignant biliary obstruction caused by cholangiocarcinoma which by Bismuth-Corlette type I and II were enrolled in our department from January 2010 to June 2018.According to the different types of stents,they were divided into irradiation stent group(implanted iodine-125 radioactive stent)and conventional metal stent group(implanted conventional metal stent).Finally,25 cases were included in irradiation stent group and 26 cases were included in conventional metal stent group.The data of TBIL,DBIL,IBIL,AST,alt,ALP,WBC,Hb,PLT and Pt at different time before and after operation were collected to evaluate the effect of two kinds of stents.To compare the effect of two kinds of stents on blood cells and coagulation function.CT,MRCP or cholangiography were performed after the operation to calculate the time of re-obstruction.The complications and survival information were recorded at 1 month,3 months,6 months,9 months,1 year,2 years,3 years and 5 years after the operation.Kaplan Meier survival analysis was performed to compare the overall survival and stent patency time of the two groups.Univariate and multivariate Cox regression analysis was used to identify the independent factors influencing the overall survival of the two groups.Results:According to the enrollment and exclusion criteria,a total of 51 patients were enrolled,including 35 males and 16 females.Among them,25 patients were implanted with iodine-125 radioactive stents and 26 patients were implanted with conventional metal stents.The success rate of stent implantation was 100%in the two groups;the TBIL of odine-125 radioactive stent was 359.99±148.99umol/L and 151.15±121.02 umol/L before operation and one week after operation,respectively;the TBIL of conventional metal stent was 427.90±173.95umol/L and 119.08±106.36umol/L before operation and one week after operation,respectively.The two groups had a significant effect of reducing jaundice at 1 week after operation,and there was no significant difference between the two groups(P=0.972).The patency time,median patency time,overall survival and median survival time were 369.20±231.642 days,310 days,334.24±193.384 days and 385.2 days in the odine-125 radioactive stent group,194.57±118.089 days,142.5 days,251.23 ±182.509 days and 274 days in the conventional metal stent group,respectively.It can be seen that the odine-125 radioactive stent has obvious stent patency time(P=0.024)and overall survival(P=0.021).There was no significant difference in the incidence of postoperative complications between the two groups(χ~2=0.917,P=0.821).The patency rate of stent(χ~2=4.581,P=0.032)and survival rate(χ~2=3.920,P=0.048)were improved after implantation of odine-125 radioactive stent.Conclusions:Compared with conventional metal stent,implantation of odine-125 radioactive stent can prolong the patency time and overall survival of patients without increasing the incidence of postoperative complications. |
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