Abstract
BACKGROUND: No reports have been published on the use of iodine-125 ((125)I) seed strips combined with double biliary self-expandable metallic stent (SEMS) for the treatment of type III and IV hilar malignant biliary obstruction (MBO). AIM: To evaluate effectiveness and safety of (125)I seed trips combined with double SEMS in treating Bismuth type III and IV hilar MBO. METHODS: This was a retrospective, observational study conducted from April 2017 to December 2022. Patients with Bismuth-Corlette type III and IV hilar MBO who underwent (125)I seed strip implantation combined with double SEMS placement were analyzed. Patient demographics, clinical characteristics, SEMS implantation methods, procedural and clinical outcomes, overall survival, stent patency duration, and complications were evaluated. RESULTS: Four types of stent implantation were utilized: (1) Type X; (2) Type T; (3) Type Y; and (4) Tandem type. The technical success rate was 94.1% (16/17), and the clinical success rate was 100% (17/17). The median overall survival time was 189.00 days ± 47.27 days (95%CI: 96.35-281.66). The median stent fluency time was 154.00 days ± 12.19 days (95%CI: 130.11-177.89). No serious complications were observed. CONCLUSION: This retrospective, observational study suggests that the combination of (125)I seed strips with double SEMS may be a safe and potentially effective approach for managing type III and IV hilar MBO patients.