Risk Factors Analysis For Biliary Infection After Percutaneous Transhepatic Biliary Stenting In Malignant Biliary Obstruction

Purpose We aim to evaluate the risk factors of biliary infection after percutaneous transhe-patic biliary stent placement in malignant biliary obstruction.Materials and Methods Between January 2012 and January 2016, patients who were treated with biliary stent for malignant biliary obstruction in three medical center (Zhongda Hospital Southeast University, Yunnan Cancer Hospital, Lishui Central Hospital, China) were retrospectively enrolled. Fellow-up within 30 days after stenting, we divided these patients in-to two groups, the infection group and the non-infection group. The main outcome measures were demographics, clinical features, preoperative imaging characteristics, procedural details. The independent risk factors for biliary infection after biliary stent placement were identified by multivariate logistic regression analysis from the risk factors selected by univariate analysis, using the χ2 test for classification variables.Results 151 patients were included in this study, in which 33 were in infection group and 118 were in non-infection group. There was no significant statistical difference in age, gender and laboratory results between these two groups. Univariate analysis for potential risk factors showed that the length of obstruction (P=0.015), preoperative PS score (P=0.028), diabetes (P=0.002), gallstones (P=0.008), pancreatic carcinoma (P=0.014), obstruction type(low/high) (P=0.009), preoperative PTCD(P=0.031) and stent across the major duodenal papilla(P=0.013) were associated with biliary infection after biliary stent placement. Logistic regression analysis showed that the length of obstruction (OR,1.057; 95%[CI],1.007 to 1.110; P=0.026), di-abetes (OR,4.047; 95%[CI],1.364 to 12.003; P=0.012), obstruction type (low/high) (OR, 0.254; 95%[CI],1.562 to 9.900; P=0.004), preoperative PTCD or not (OR,0.332; 95%[CI], 0.123 to 0.894; P=0.029) were independent risk factors of biliary infection after biliary stent placement.Conclusion The length of obstruction, diabetes, high level biliary obstruction and non-preoperative PTCD were independent risk factors of biliary infection after percutaneous transhepatic biliary stent placement in malignant biliary obstruction.