Percutaneous transhepatic biliary preset implantation of after-loading radiotherapy catheter for the treatment of bile duct carcinoma of ampulla: preliminary results of 10 cases

Objective: To discuss the safety and feasibility of percutaneous transhepatic biliary preset implantation of after-loading radiotherapy catheter in treating bile duct carcinoma of ampulla. Methods: A total of 10 patients with carcinoma of ampulla were collected. After percutaneous transhepatic biliary stent implantation was accomplished, the after-loading radiotherapy catheter was inserted via the guide wire. Based on the lesion's location, the positioning of both the catheter tip and the simulation radioactive source implanted through catheter was conducted. Each time before irradiation, the positions of the catheter and the radioactive source were reset under CT or fluoroscopic guidance in order to ensure that the lesion could get adequate internal irradiation dose. Results: Percutaneous transhepatic biliary implantation of after-loading radiotherapy catheter and the positioning of simulation radioactive source were successfully accomplished in all 10 patients, and the total internal irradiation dose was completed within 5-7 days after catheter implantation. No severe complications occurred during the whole therapeutic process. Conclusion: The technology of percutaneous transhepatic biliary preset implantation of after-loading radiotherapy catheter is safe and feasible, it carries high success rate with less complications. This therapy can improve the patency rate of biliary stent, and, as a palliative treatment, it is suitable for patients with carcinoma of ampulla. This treatment is worthy of application and promotion. (authors)