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World J Gastroenterol. Jan 14, 2006; 12(2): 331-335
Published online Jan 14, 2006. doi: 10.3748/wjg.v12.i2.331
Treatment of malignant biliary obstruction by combined percutaneous transhepatic biliary drainage with local tumor treatment
Xiao-Jun Qian, Ren-You Zhai, Ding-Ke Dai, Ping Yu, Li Gao
Xiao-Jun Qian, Ren-You Zhai, Ding-Ke Dai, Ping Yu, Department of Interventional Radiology, Beijing Chaoyang Hospital, Capital University of Medical Sciences, Beijing 100020, China
Li Gao, Department of Radiotherapy, Cancer Institute & Cancer Hospital, Chinese Academy of Medical sciences, Peking Union Medical College, Beijing 100020, China
Supported by the Natural Science Foundation of Beijing, No. 7982035
Correspondence to: Xiao-Jun Qian, Department of Interventional Radiology, Beijing Chaoyang Hospital, Capital University of Medical Sciences, 8 Baijiazhuang lu, Chaoyang District, Beijing 100020, China. qian_xj_70@yahoo.com.cn
Telephone: +86-10-85231541
Received: June 13, 2005
Revised: June 28, 2005
Accepted: July 13, 2005
Published online: January 14, 2006
Abstract

AIM: To evaluate the utility of local tumor therapy combined with percutaneous transhepatic biliary drainage (PTBD) for malignant obstructive biliary disease.

METHODS: A total of 233 patients with malignant biliary obstruction were treated in our hospital with PTBD by placement of metallic stents and/or plastic tubes. After PTBD, 49 patients accepted brachytherapy or extra-radiation therapy or arterial infusion chemotherapy. The patients were followed up with clinical and radiographic evaluation. The survival and stent patency rate were calculated by Kaplan-Meier survival analysis.

RESULTS: Twenty-two patients underwent chemotherapy (11 cases of hepatic carcinoma, 7 cases of pancreatic carcinoma, 4 cases of metastatic lymphadenopathy), and 14 patients received radiotherapy (10 cases of cholangiocarcinoma, 4 cases of pancreatic carcinoma), and 13 patients accepted brachytherapy (7 cases of cholangiocarcinoma, 3 cases of pancreatic carcinoma, 4 cases of metastatic lymphadenopathy). The survival rate of the local tumor treatment group at 1, 3, 6, and 12 months was 97.96%, 95.92%, 89.80%, and 32.59% respectively, longer than that of the non treatment group. The patency rate at 1, 3, 6, and 12 months was 97.96%, 93.86%, 80.93%, and 56.52% respectively. The difference of patency rate was not significant between treatment group and non treatment group.

CONCLUSION: Our results suggest that local tumor therapy could prolong the survival time of patients with malignant biliary obstruction, and may improve stent patency.

Keywords: Obstructive jaundice; PTBD; Stent; Chemotherapy; Radiotherapy; Brachytherapy