Comparison of two different seeds strand fabrication and implantation methods combined with metallic stent in the treatment of malignant obstructive jaundice

Comparison of two different seeds strand fabrication and implantation methods combined with metallic stent in the treatment of malignant obstructive jaundice | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Comparison of two different seeds strand fabrication and implantation methods combined with metallic stent in the treatment of malignant obstructive jaundice Zhaohong Peng, Wenfei Du, Jian Wang, Yifan Zhang, Di Wu, Haisu Wang, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8405568/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background Malignant obstructive jaundice presents a challenging clinical scenario where biliary stenting serves as a pivotal palliative intervention to restore biliary drainage. While the combination of a biliary stent with an 125 I seeds strand has emerged as a mainstream strategy to prolong stent patency and enhance patient survival, the conventional approach is significantly hampered by its propensity to cause substantial bile duct injury and a high associated rate of complications. In response to these limitations, this study introduced and evaluated a refined methodology. We developed an improved technique for fabricating the 125 I seeds strand and implemented a novel, less invasive implantation protocol. The primary objective of this investigation was to systematically compare this optimized approach against conventional methods, assessing its clinical feasibility, safety profile, and therapeutic efficacy in the management of patients with malignant obstructive jaundice. Methods A cohort of 165 patients with malignant obstructive jaundice, who were admitted to our hospital between January 2018 and February 2024, was retrospectively reviewed and randomly allocated into two groups. Group A, comprising 59 patients, underwent the conventional implantation procedure for the combined biliary stent and 125 I seeds strand. In contrast, Group B, consisting of 49 patients, received the same combination therapy but utilizing the novel, refined implantation technique. The primary endpoints for comparison between the two cohorts included therapeutic efficacy, the incidence of intraoperative and postoperative complications, duration of stent patency, and overall patient survival. For all statistical analyses, a p-value of less than 0.05 was predefined as the threshold for statistical significance. Results The procedural success rate for PTBSIS was 100% across both cohorts. One month following the intervention, comparative analysis with pre-PTBD baseline levels demonstrated a statistically significant improvement in liver function parameters for all patients (P 0.05). However, subsequent analysis confirmed that the incidence of procedure-related complications was significantly higher in Group A compared to Group B, a finding that held true for both intraoperative and postoperative events (P < 0.05). Furthermore, long-term outcomes strongly favored the innovative approach. Patients in Group B achieved a markedly longer median stent patency time and a superior overall median survival period, with both differences being statistically highly significant (P < 0.001). Conclusions The refined fabrication technique and novel implantation methodology for the 125 I seeds strand, when combined with biliary stenting, constitutes a safe and effective therapeutic strategy for malignant obstructive jaundice. Compared to the conventional approach, this optimized intervention significantly mitigates procedure-related complications, while concurrently extending both stent patency and overall patient survival, thereby offering a superior clinical outcome. Trial registration This clinical trial was approved by The First Affiliated Hospital of Anhui Medical University (LLSC20221301) and registered in the Clinical Trials (NCT07381439, registered on January 14, 2026). Retrospectively registered. 125I seeds strand Complications Malignant obstructive jaundice Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 19 Apr, 2026 Reviewers agreed at journal 11 Apr, 2026 Reviewers invited by journal 02 Apr, 2026 Editor assigned by journal 20 Feb, 2026 Editor invited by journal 05 Feb, 2026 Submission checks completed at journal 04 Feb, 2026 First submitted to journal 04 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8405568","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":617419564,"identity":"84d32162-0964-4ffa-b27f-a151a96b9d91","order_by":0,"name":"Zhaohong Peng","email":"","orcid":"","institution":"First Affiliated Hospital of Anhui Medical University","correspondingAuthor":false,"prefix":"","firstName":"Zhaohong","middleName":"","lastName":"Peng","suffix":""},{"id":617419566,"identity":"ccc50cd6-4e9c-4a3a-9cab-fe2cf49a664b","order_by":1,"name":"Wenfei Du","email":"","orcid":"","institution":"First Affiliated Hospital of Anhui 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jaundice","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-cancer","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcan","sideBox":"Learn more about [BMC Cancer](http://bmccancer.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bcan/default.aspx","title":"BMC Cancer","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"125I seeds strand, Complications, Malignant obstructive jaundice","lastPublishedDoi":"10.21203/rs.3.rs-8405568/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8405568/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eBackground\u003c/b\u003e\u003c/p\u003e \u003cp\u003eMalignant obstructive jaundice presents a challenging clinical scenario where biliary stenting serves as a pivotal palliative intervention to restore biliary drainage. While the combination of a biliary stent with an \u003csup\u003e125\u003c/sup\u003eI seeds strand has emerged as a mainstream strategy to prolong stent patency and enhance patient survival, the conventional approach is significantly hampered by its propensity to cause substantial bile duct injury and a high associated rate of complications. In response to these limitations, this study introduced and evaluated a refined methodology. We developed an improved technique for fabricating the \u003csup\u003e125\u003c/sup\u003eI seeds strand and implemented a novel, less invasive implantation protocol. The primary objective of this investigation was to systematically compare this optimized approach against conventional methods, assessing its clinical feasibility, safety profile, and therapeutic efficacy in the management of patients with malignant obstructive jaundice.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003e A cohort of 165 patients with malignant obstructive jaundice, who were admitted to our hospital between January 2018 and February 2024, was retrospectively reviewed and randomly allocated into two groups. Group A, comprising 59 patients, underwent the conventional implantation procedure for the combined biliary stent and \u003csup\u003e125\u003c/sup\u003eI seeds strand. In contrast, Group B, consisting of 49 patients, received the same combination therapy but utilizing the novel, refined implantation technique. The primary endpoints for comparison between the two cohorts included therapeutic efficacy, the incidence of intraoperative and postoperative complications, duration of stent patency, and overall patient survival. For all statistical analyses, a p-value of less than 0.05 was predefined as the threshold for statistical significance.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe procedural success rate for PTBSIS was 100% across both cohorts. One month following the intervention, comparative analysis with pre-PTBD baseline levels demonstrated a statistically significant improvement in liver function parameters for all patients (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Notably, when comparing the two groups at this one-month mark, no significant intergroup differences were observed in key hepatic indices, including ALT, AST, and TBIL levels (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). However, subsequent analysis confirmed that the incidence of procedure-related complications was significantly higher in Group A compared to Group B, a finding that held true for both intraoperative and postoperative events (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Furthermore, long-term outcomes strongly favored the innovative approach. Patients in Group B achieved a markedly longer median stent patency time and a superior overall median survival period, with both differences being statistically highly significant (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusions\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe refined fabrication technique and novel implantation methodology for the \u003csup\u003e125\u003c/sup\u003eI seeds strand, when combined with biliary stenting, constitutes a safe and effective therapeutic strategy for malignant obstructive jaundice. Compared to the conventional approach, this optimized intervention significantly mitigates procedure-related complications, while concurrently extending both stent patency and overall patient survival, thereby offering a superior clinical outcome.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTrial registration\u003c/b\u003e\u003c/p\u003e \u003cp\u003e This clinical trial was approved by The First Affiliated Hospital of Anhui Medical University (LLSC20221301) and registered in the Clinical Trials (NCT07381439, registered on January 14, 2026). 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