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Abstract：
UNASSIGNED: Biliary stent dysfunction is challenging to treat in clinic. The retrograde track method (RTM) has a promising clinical application in the reopening of dysfunctional biliary stents. This study aimed to evaluate the clinical value of the RTM in reopening dysfunctional biliary stents.
UNASSIGNED: From February 2013 to January 2020, 151 patients underwent percutaneous transhepatic biliary interventional procedures for reopening dysfunctional biliary stents at the First Affiliated Hospital of Zhengzhou University, and 25 patients (12 females, 13 males; mean age 63.12 years old) underwent the RTM after anterograde reopening dysfunction biliary stent failure. Technical success, clinical success, irradiation dose, procedure time, complications, and overall survival (OS) were recorded, and levels of total bilirubin (TBIL), direct bilirubin (DB), alanine aminotransferase (ALT), albumin (ALB), and carbohydrate antigen-199 (CA-199) were compared before treatment and 1 month after treatment.
UNASSIGNED: The technical and clinical success rates were 100% and 96%, respectively, and the irradiation dose and procedure times were 774.07±330.80 mGy and 45.16±9.48 min, respectively. Two patients (8%) experienced major complications. The median OS was 10.73 months [95% confidence interval (CI): 9.37-12.09]. Compared with pretreatment values, the mean levels at 1 month after RTM administration for TBIL (189.47±59.20 vs. 44.65±16.12 µmol/L), DB (144.21±55.83 vs. 27.95±13.86 µmol/L), ALT (89.62±30.85 vs. 49.44±14.25 U/L), and CA-199 (584.59±269.82 vs. 176.76±100.68 U/mL) showed significant decreases, while that of ALB (36.32±2.05 vs. 40.22±1.95 g/L) showed a significant increase (all P values <0.05).
UNASSIGNED: RTM is an effective alternative treatment method when anterograde reopening of a dysfunctional biliary stent occurs.
UNASSIGNED: From February 2013 to January 2020, 151 patients underwent percutaneous transhepatic biliary interventional procedures for reopening dysfunctional biliary stents at the First Affiliated Hospital of Zhengzhou University, and 25 patients (12 females, 13 males; mean age 63.12 years old) underwent the RTM after anterograde reopening dysfunction biliary stent failure. Technical success, clinical success, irradiation dose, procedure time, complications, and overall survival (OS) were recorded, and levels of total bilirubin (TBIL), direct bilirubin (DB), alanine aminotransferase (ALT), albumin (ALB), and carbohydrate antigen-199 (CA-199) were compared before treatment and 1 month after treatment.
UNASSIGNED: The technical and clinical success rates were 100% and 96%, respectively, and the irradiation dose and procedure times were 774.07±330.80 mGy and 45.16±9.48 min, respectively. Two patients (8%) experienced major complications. The median OS was 10.73 months [95% confidence interval (CI): 9.37-12.09]. Compared with pretreatment values, the mean levels at 1 month after RTM administration for TBIL (189.47±59.20 vs. 44.65±16.12 µmol/L), DB (144.21±55.83 vs. 27.95±13.86 µmol/L), ALT (89.62±30.85 vs. 49.44±14.25 U/L), and CA-199 (584.59±269.82 vs. 176.76±100.68 U/mL) showed significant decreases, while that of ALB (36.32±2.05 vs. 40.22±1.95 g/L) showed a significant increase (all P values <0.05).
UNASSIGNED: RTM is an effective alternative treatment method when anterograde reopening of a dysfunctional biliary stent occurs.
摘要：
■胆道支架功能障碍在临床治疗中具有挑战性。逆行追踪法（RTM）在功能失调的胆道支架的重新开放中具有广阔的临床应用前景。这项研究旨在评估RTM在重新打开功能失调的胆道支架中的临床价值。
2013年2月至2020年1月，郑州大学第一附属医院151例患者接受经皮肝穿胆道介入手术，以重新打开功能失调的胆道支架，和25名患者（12名女性，13名男性；平均年龄63.12岁）在顺行重新开放功能障碍胆道支架衰竭后接受了RTM。技术上的成功,临床成功，辐照剂量,程序时间,并发症,记录总生存期（OS），和总胆红素（TBIL）水平，直接胆红素（DB），丙氨酸氨基转移酶（ALT），白蛋白（ALB），治疗前和治疗后1个月比较糖类抗原-199(CA-199)。
■技术和临床成功率分别为100％和96％，分别,照射剂量和手术时间分别为774.07±330.80mGy和45.16±9.48min，分别。两名患者（8％）经历了重大并发症。中位OS为10.73个月[95%置信区间（CI）：9.37-12.09]。与预处理值相比，TBILRTM给药后1个月的平均水平（189.47±59.20vs.44.65±16.12µmol/L），DB(144.21±55.83vs.27.95±13.86µmol/L),ALT（89.62±30.85vs.49.44±14.25U/L),和CA-199（584.59±269.82vs.176.76±100.68U/mL)显示显著下降，而ALB（36.32±2.05vs.40.22±1.95g/L）显示显着增加（所有P值<0.05）。
■当发生功能失调的胆道支架的顺行重新开放时，RTM是一种有效的替代治疗方法。
2013年2月至2020年1月，郑州大学第一附属医院151例患者接受经皮肝穿胆道介入手术，以重新打开功能失调的胆道支架，和25名患者（12名女性，13名男性；平均年龄63.12岁）在顺行重新开放功能障碍胆道支架衰竭后接受了RTM。技术上的成功,临床成功，辐照剂量,程序时间,并发症,记录总生存期（OS），和总胆红素（TBIL）水平，直接胆红素（DB），丙氨酸氨基转移酶（ALT），白蛋白（ALB），治疗前和治疗后1个月比较糖类抗原-199(CA-199)。
■技术和临床成功率分别为100％和96％，分别,照射剂量和手术时间分别为774.07±330.80mGy和45.16±9.48min，分别。两名患者（8％）经历了重大并发症。中位OS为10.73个月[95%置信区间（CI）：9.37-12.09]。与预处理值相比，TBILRTM给药后1个月的平均水平（189.47±59.20vs.44.65±16.12µmol/L），DB(144.21±55.83vs.27.95±13.86µmol/L),ALT（89.62±30.85vs.49.44±14.25U/L),和CA-199（584.59±269.82vs.176.76±100.68U/mL)显示显著下降，而ALB（36.32±2.05vs.40.22±1.95g/L）显示显着增加（所有P值<0.05）。
■当发生功能失调的胆道支架的顺行重新开放时，RTM是一种有效的替代治疗方法。
