Unilateral and bilateral radioactive stent insertion in patients diagnosed with inoperable hilar cholangiocarcinoma: a comparative analysis

Abstract

Abstract Background: While hilar cholangiocarcinoma (HCCA) patients commonly undergo radioactive stent (RS) insertion treatment, the relative benefits of unilateral versus bilateral RS insertion procedures remain to be established. Accordingly, this study was designed to evaluate the relative safety and efficacy of percutaneous bilateral and unilateral RS insertion for patients with HCCA. Materials and Methods: In total, 126 HCCA patients that underwent unilateral (n=64) or bilateral (n=62) RS insertion from January 2017 - December 2021 were included in this analysis. Treatment efficacy and long-term outcomes were compared between groups. Results: The respective technical success rates in the unilateral and bilateral groups were 90.6% (58/64) and 93.5% (58/62) (P = 0.782). Both groups exhibited comparable medial postoperative bilirubin levels (100 vs. 99 μmol/L; P = 0.501), and restenosis occurred in 12 (20.7%) and 15 (25.9%) patients over the follow-up interval (P = 0.510). The median stent patency in the unilateral and bilateral groups was 189 and 210 days, respectively (P = 0.796), while the median overall survival interval was 222 and 229 days, respectively (P = 0.969). Comparable cholangitis (17.2% vs. 22.4%, P = 0.485) and cholecystitis (3.4% vs. 3.4%, P = 1.000) rates were also detected in these two groups. Conclusions: In summary, HCCA patients exhibit comparable efficacy when undergoing unilateral and bilateral radioactive stenting, suggesting that unilateral RS can be routinely performed owing to the simpler nature of this procedure.