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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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2/2023
vol. 18
 
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Interventional radiology
abstract:
Randomized controlled trial

Radioactive stent insertion for inoperable hilar cholangiocarcinoma: a prospective randomized controlled trial

Tao Song
1
,
An-Qiang Feng
2
,
Yu-Fei Fu
3
,
Chi Cao
1
,
You-Bin Wang
4
,
Jin-Ling Feng
3

  1. Department of Gastrointestinal Surgery, Xuzhou Central Hospital, Xuzhou, China
  2. Department of Digestive Disease, Xuzhou Central Hospital, Xuzhou, China
  3. Department of Medical Imaging, Xuzhou Central Hospital, Xuzhou, China
  4. Department of Interventional Radiology, Xuzhou Cancer Hospital, Xuzhou, China
Videosurgery Miniinv 2023; 18 (2): 254–263
DOI: https://doi.org/10.5114/wiitm.2022.123312
Online publish date: 2022/12/22
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Introduction
Hilar cholangiocarcinoma (HC) is the leading cause of hilar biliary obstruction. Radioactive stent insertion has been utilized extensively for inoperable HC patients. Aim: To assess the relative clinical outcomes of inoperable HC patients who underwent either normal or radioactive stent insertion.

Material and methods
This single-center, prospective, randomized, open-label study enrolled 90 inoperable HC patients from April 2021 to March 2022 and randomly assigned them to normal or radioactive stent groups (n = 45/group), with clinical data then being compared between these groups.

Results
Technical success rates in the normal and radioactive stent insertion groups were 93.3% and 97.9%, respectively (p = 1.000), and clinical success rates were similarly consistent in both groups (95.3% vs. 97.7%, p = 0.983). Individuals in the radioactive stent group exhibited significantly longer median stent patency as compared to the normal stent group (195 days vs. 115 days, p < 0.001), and median overall survival (OS) was also significantly increased in the normal stent group (242 days vs. 125 days, p = 0.002). In the normal stent insertion group, 6 (14.3%) and 5 (11.9%) patients experienced early and late postoperative complications, respectively. Additionally, early and late postoperative complications impacted 7 (16.3%) and 8 (18.6%) patients in the radioactive stent insertion group, respectively. Complication rates were comparable in these 2 patient groups.

Conclusions
Radioactive stent insertion represents a safe and effective strategy for patients with inoperable HC, potentially contributing to prolonged stent patency and OS relative to normal stent insertion.

keywords:

stent, radioactive, hilar cholangiocarcinoma, randomized controlled trial
  
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