Comparative Study of Percutaneous Transhepatic Biliary Stent Placement with or without Iodine-125 Seeds for Treating Patients with Malignant Biliary Obstruction.

PURPOSE: To prospectively evaluate safety and efficacy of biliary stent placement with iodine-125 (125I) seeds in patients with malignant obstructive jaundice (MOJ). MATERIALS AND METHODS: From July 2011 to June 2014, 55 patients were enrolled (group A, 11 men and 17 women, mean age 70.93 y ± 8.58; group B, 14 men and 13 women, mean age 70.26 y ± 9.71). All patients were randomly assigned to placement of a biliary stent with 125I seeds (group A) or biliary stent only (group B). After stent placement, outcomes were measured regarding relief of MOJ. Clinical success rate, survival time, and safety were recorded. P < .05 was considered to indicate significant difference. RESULTS: Stents were successfully placed in all 55 patients. MOJ was relieved in all patients, and there were no significant differences in complications related to stent insertion between the 2 groups. Mean and median stent patency were 191 days ± 19.8 (95% confidence interval [CI], 152-230 d) and 179 days ± 191.4 (95% CI, 87-267 d) in group A and 88.3 days ± 16.3 (95% CI, 61-114 d) and 77 days ± 88.2 (95% CI, 65-86 d) in group B (P < .001, log-rank test). Mean and median survival time were 222.6 days ± 21.0 (95% CI, 181-263 d) and 241 days ± 18.2 (95% CI, 179-270 d) in group A and 139.1 days ± 14.5 (95% CI, 110-167 d) and 142 days ± 16.3 (95% CI, 83-177 d) in group B (P < .001, log-rank test). CONCLUSIONS: 125I seeds combined with biliary stent placement could significantly improve stent patency. The procedure seems to be safe and to extend survival compared with self-expandable biliary stent placement.

Effects of albendazole nanoparticles in mice with hepatic echinococosis: Portal vein cannulation versus intravenous administration.

To compare the ABZ and its metabolites concentration in cyst tissue of hepatic alveolar echinococcosis administered by different routes, forty male Wistar rats receiving albendazole nanoparticles from tail vein and portal vein were divided into two groups, the concentration of ABZ and its metabolites ABZSO, ABZSO2, in the cyst tissue, were analyzed by HPLC at 2, 4, 8, 24, 36 h after administration. The parent drug and its metabolites were detected in plasm and the cyst tissue after portal cannulation and intravenous administration. The last results were the concentration of ABZ in the portal cannulation group was higher than in the intravenous group at every time point (p < 0.05). Compared to the intravenous group, the portal cannulation administration of ABZ led to a lower plasm concentration of ABZ. The concentration of ABZ and the active ABZSO were significantly higher in the portal cannulation group than that of the intravenous group.

[Pathological changes of after trans-portal vein chemoembolization Echinococcus multilocularis in the liver of infected rats].

OBJECTIVE: To observe the morphological change in the pathological process of Echinococcus multilocularis in liver of infected rats after treatment with liposome entrapped albendazole and iodized oil suspension through portal vein, and investigate its efficacy against hepatic alveolar echinococcosis. METHODS: One Echinococcus multilocularis-infected rat served as control. Another 19 infected rats were infused with 0.2ml liposome entrapped albendazole and iodized oil suspension through portal vein. At 4, 7 and 10 d after treatment, the rats were sacrificed for further observation. The E. multilocularis metacestodes were collected, and the pathological change of alveolar hydatid was observed with hematoxylin-eosin staining and toluidine blue staining. RESULTS: In four days post treatment, E. multilocularis metacestodes were normal On the 7th day and 10th day post treatment, the major pathological change was degeneration and necrosis, respectively. A great quantity of liposomes and iodized oil deposited in the metacestodes, and caused breakdown of E. multilocularis tissue, collapse of cysts, cataplasia of germinal layer and laminated layer. CONCLUSION: Interventional therapy trans-hepatic vein may be an effective way to treat hepatic alveolar echinococcosis.