Cheng G, Li X S, Zhang M
Department of Interventional Therapy, Affiliated Hospital of Jiangnan University, Wuxi, China.
Hippokratia. 2023 Jul-Sep;27(3):89-98.
Cholangiocarcinoma (CCA) may invade the bile duct, causing malignant biliary obstruction, which is mainly treated by percutaneous biliary stenting. Biliary tract infection after stenting is a severe and common complication in the early postoperative period. In this study, we investigated the risk factors predisposing to infection after percutaneous biliary stenting in patients with CCA and its effect on prognosis. Our findings might reference early clinical prevention, diagnosis, and treatment.
We analyzed retrospective data regarding 337 patients who developed CCA and underwent percutaneous biliary stenting from December 2016 to December 2021. We collected the patients' general characteristics and clinical data utilizing a questionnaire regarding general information designed by the investigator. We performed the t-test and chi-square test to investigate the association between the clinical characteristics and postoperative infection and binary logistic regression to analyze the independent risk factors for patients developing postoperative infections. We used the Cox risk regression to determine each factor's effect on patients' survival status.
Seventy-three cases of postoperative infection occurred in total, with an estimated infection rate of 21.7 %. Logistic regression analysis revealed that age [odds ratio (OR) =1.041, p =0.031], presence of combined gallstones (OR =2.200, p =0.030), stent type (OR =2.607, p =0.003), administration of preoperative prophylactic antibiotics (OR =0.473, p =0.042), presence of intraoperative complications of biliary bleeding (OR =2.452, p =0.017), presence of postoperative biliary pneumoperitoneum (OR =2.355, p =0.013), duration of surgery (OR =1.026, p =0.008), preoperative serum albumin (Alb) (OR =0.946, p =0.005), and preoperative hemoglobin (Hb) (OR =0.964, p =0.014) were the independent factors influencing postoperative infection development. The Cox risk regression analysis showed that infection occurrence was an independent factor influencing patients' survival time (OR =1.041, p =0.031).
Biliary tract infection is the most common complication after biliary interventions, and severe infection may even lead to death. Clinical studies should analyze and evaluate patients' clinical characteristics, perioperative indicators, and relevant serological indicators, identify relevant risk factors, and administer prompt treatment to reduce the chance of infection and improve patients' prognosis. HIPPOKRATIA 2023, 27 (2):89-98.
胆管癌（CCA）可侵犯胆管，导致恶性胆道梗阻，主要通过经皮胆道支架置入术治疗。支架置入术后胆道感染是术后早期严重且常见的并发症。在本研究中，我们调查了CCA患者经皮胆道支架置入术后发生感染的危险因素及其对预后的影响。我们的研究结果可能为早期临床预防、诊断和治疗提供参考。
我们分析了2016年12月至2021年12月期间337例发生CCA并接受经皮胆道支架置入术患者的回顾性数据。我们使用研究者设计的一般信息问卷收集患者的一般特征和临床资料。我们进行t检验和卡方检验以研究临床特征与术后感染之间的关联，并进行二元逻辑回归分析以分析患者发生术后感染的独立危险因素。我们使用Cox风险回归来确定每个因素对患者生存状态的影响。
共发生73例术后感染，估计感染率为21.7%。逻辑回归分析显示，年龄[比值比（OR）=1.041，p =0.031]、合并胆结石（OR =2.200，p =0.030）、支架类型（OR =2.607，p =0.003）、术前预防性使用抗生素（OR =0.473，p =0.042）、术中发生胆道出血并发症（OR =2.452，p =0.017）、术后发生胆源性气腹（OR =2.355，p =0.013）、手术时间（OR =1.026，p =0.008）、术前血清白蛋白（Alb）（OR =0.946，p =0.005）和术前血红蛋白（Hb）（OR =0.964，p =0.014）是影响术后感染发生的独立因素。Cox风险回归分析表明，感染的发生是影响患者生存时间的独立因素（OR =1.041，p =0.031）。
胆道感染是胆道介入术后最常见的并发症，严重感染甚至可能导致死亡。临床研究应分析和评估患者的临床特征、围手术期指标和相关血清学指标，识别相关危险因素，并及时进行治疗，以降低感染几率，改善患者预后。《希波克拉底》2023年，27（2）：89 - 98。
