经胆道支架置入放射性粒子条治疗恶性胆道梗阻

目的探讨经胆道支架置入放射性粒子条治疗恶性胆道梗阻的疗效。 方法38例恶性胆道梗阻的患者，应用¹²⁵I粒子，每个¹²⁵I粒子长4.5 mm、直径0.8 mm，送入导管制备粒子条。先行经皮肝穿刺胆道引流（PTCD）术；导丝经皮通过梗阻段，先行球囊导管扩张，后行经皮胆道支架成形术；然后经支架置入8～10F胆道引流管；再将装有粒子条的导管在透视下经胆道引流管送入所需照射部位，包敷固定引流管体外部分或包埋于皮下。 结果38例中36例成功施行经皮胆道支架成形术及放射性粒子条置入术，术后患者的胆红素均降至正常或接近正常（P<0.05），未出现明显不良反应。 讨论经皮胆道支架成形术后联合放射性粒子条置入术治疗恶性胆道梗阻是一种安全有效的方法。

Treatment of malignant biliary obstruction by percutaneous transhepatic insertion of biliary stent combined with radioactive seed implantation therapy

ObjectiveTo explore effect of percutaneous transhepatic insertion of biliary stent implanted with radioactive seeds in treatment of alignant biliary obstruction. Methods¹²⁵I seed, each of which was 4.5 mm in length and 0.8 mm in diameter, was applied in 38 patients with malignant biliary obstruction. They were led to a catheter for preparing ¹²⁵I seed sliver. The patients were given percutaneous transhepatic cholangial drainage (PTCD) at the first step; then a percutaneous puncture was done through the obstructed section by a guide wire. The patients were given balloon catheter dilatation therapy before percutaneous transhepatic insertion of biliary stent (PTIBS). Biliary drainage catheter with the size of 8—10F were implanted. Finally the catheter with ¹²⁵I seeds sliver was sent to the part to be radiated via the biliary drainage catheter and the exposed part of the biliary drainage catheter which stretched outside the patients’ body was wrapped or imbedded beneath the skin. ResultsAmong 38 patients, the successful implementation of PTIBS and radioactive seed implantation treatment in 36 cases. All these patients had their bilirubin values return to or very close to normal level (P<0.05). No obvious side effect was obsreved. ConclusionsPTIBS combined with radioactive seed implantation therapy in treatment of malignant biliary obstruction is safe and effective.