Biliary Self-expandable Metallic Stent Combined with Iodine-125 Seeds in the Treatment of Malignant Biliary Obstruction (Bismuth type I or II)

Abstract Background:Biliary self-expandable metallic stent(SEMS) combined with iodine-125(125I) seeds are increasingly used in patients with malignant biliary obstruction (MBO), The purpose of this study was to evaluate the safety and efficacy of SEMS combined with 125I seeds in the treatment of Bismuth type I or II MBO.Methods:The clinical data of 74 cases of MBO treated with percutaneous SEMS combined with 125I seeds (combination group) and 81 cases of MBO treated with SEMS implantation alone (control group) in our hospital from January 2015 to December 2019 were retrospectively analyzed.Results:The surgical success rate of the two groups was 100%, and no surgery-related deaths occurred. The liver function of each group was significantly improved after 1 week and 1 month of follow-up. There was no significant difference in short-term efficacy or complications between the two groups (P> 0.05). The average biliary opening times of the combined group and control group were 9.01±4.38 months and 6.79±3.13 months, respectively (P <0.001). The average postoperative survival time was 12.08±5.38 months and 9.10±4.16 months, respectively (P <0.001). Univariate and multivariate analyses showed that the type of biliary stent and liver metastasis were independent factors affecting survival.Conclusions: SEMS combined with 125I seeds is a safe, effective and feasible palliative treatment for patients with Bismuth type I or II MBO, as it can delay the recurrence of jaundice and prolong the survival time of patients.