Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2020; 8(19): 4603-4608
Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4603
Novel brachytherapy drainage tube loaded with double 125I strands for hilar cholangiocarcinoma: A case report
Qin-Yu Lei, De-Chao Jiao, Xin-Wei Han
Qin-Yu Lei, De-Chao Jiao, Xin-Wei Han, Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Author contributions: Lei QY and Jiao DC analyzed the data and wrote the paper; Han XW designed and performed the research.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xin-Wei Han, MD, PhD, Chief Doctor, Director, Professor, Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1 East Jianshe Road, Zhengzhou 450052, Henan Province, China. 13592583911@163.com
Received: April 23, 2020
Peer-review started: April 23, 2020
First decision: April 29, 2020
Revised: May 11, 2020
Accepted: August 25, 2020
Article in press: August 25, 2020
Published online: October 6, 2020
Processing time: 157 Days and 21.7 Hours
Abstract
BACKGROUND

Hilar cholangiocarcinoma (CC) is a common malignant tumor with high malignancy and poor prognosis. Most patients have lost the opportunity to undergo radical surgery when diagnosed. Although palliative drainage or biliary stent placement is a preferable choice, the tumor cannot be controlled. This study aimed to develop a novel brachytherapy drainage tube for low-dose-rate brachytherapy with an effective drainage, thereby prolonging the survival time of patients.

CASE SUMMARY

A 54-year-old male patient had undergone choledochal stent implantation due to obstructive jaundice. He was admitted to the hospital because of the recurrence of jaundice. Preoperative imaging and pathological biopsy revealed hilar CC (Bismuth-Corlette type IIIa). First, the patient underwent percutaneous transhepatic cholangial drainage and the symptoms of jaundice gradually relieved. To further treat hilar CC and remove the biliary drainage tube as far as possible, the patient chose to use the novel brachytherapy drainage tube after a multi-disciplinary consultation. After 1 mo of brachytherapy, the re-examination revealed that the obstructive lesions disappeared, and the drainage tube was finally removed. During the following 10 mo of follow-up, the patient's hilar CC did not recur.

CONCLUSION

The novel brachytherapy drainage tube may be a new choice for patients with unresectable hilar CC.

Keywords: Biliary drainage tube; Brachytherapy; Case report; Hilar cholangiocarcinoma; Interventional therapy

Core Tip: This study aimed to develop a novel biliary drainage tube for low-dose-rate brachytherapy, which had a central cavity for drainage and bilateral cavities to fill 125I seeds. It was placed in a patient with unresectable hilar cholangiocarcinoma, and the obstruction was relieved 1 mo later. After 2 wk of observation, the biliary drainage tube was successfully removed, thereby improving the quality of life of the patient. No complications occurred, and obstructive jaundice did not recur during the follow-up. It was concluded that the novel brachytherapy drainage tube might be a novel choice for patients with unresectable hilar cholangiocarcinoma.