Clinical Analysis Of The Safety And Efficacy Of Modified Single Pigtail Pancreatic Duct Stent For ERCP Treatment Of Common Bile Duct Stones

Objective:To explore the clinical value of 7Fr modified single pigtail plastic pancreatic duct stent for biliary drainage.Methods:The clinical data of 121 patients with choledocholithiasis who underwent ERCP lithotomy and biliary drainage in the Hepatobiliary Department of the Affiliated Hospital of Guizhou Medical University from April 2021 to June 2022 were collected.According to the postoperative biliary drainage mode,they were divided into the modified stent group(n=59)and the nasobiliary drainage group(n=60).The modified stent group used the modified 7Fr single pigtail plastic pancreatic stent drainage,and the nasobiliary drainage group used the nasobiliary drainage.The clinical data of the two groups were analyzed retrospectively,To observe the self-falling of the stent in the modified stent group,and compare the clinical efficacy,postoperative comfort and postoperative complications of the two groups.The measurement data in line with normal distribution were compared with independent sample t-test;Mann-Whitney U test was used to compare the measurement data of non-normal distribution between groups;Comparison of counting data between two groups χ2 Test and compare.Results:The stone clearance rate of the two groups was 100%.The serum TBil of the two groups after operation was 22.7(11.4,84.1)vs 17.7(12.1,34.2),Z=2.271,P=0.023;30.2(15.4,66.0)vs16.25(10.9,25.4),Z=-3.567,P<0.001]、DBil[12.5(4.7,62.1)vs8.3(5.0,22.0),Z=-1.992,P=0.046;18.3(7.6,46.7)vs7.7(5.0,14.6),Z=-3.176,P=0.001]、ALP[183(108,12)vs120(83,238),Z=-2.027,P=0.043;187(111.5,314.25)vs120.5(90,232),Z=-2.59,P=0.01]、ALT[78.8(34.8,225.9)vs51.4(32.7,88.9),Z=-2.371,P=0.018;129.6(42.0,271.3)vs48.6(23.4,134.5),Z=-3.176,P=0.001],AST[53.1(21.8,111.3)vs32.9(22.3,51.1),Z=-2247,P=0.025;63.7(33.7,172.6)vs32.0(20.4,49.7),Z=-4.475,P<0.001]、GGT[301.2(118.3、451,9)vsl 85.0(174.9,542.3),Z=-1.994,P=0.046;361.9(174.9542.3)vs 165.5(87.5340.7),Z=-3.217,P=0.001]were significantly lower than those before operation The postoperative comfort score of patients in the modified stent group was lower than that in the naso-biliary drainage group(2.1 ±1.2 vs 6.2±1.7,t=0.001,P=0.048),and the postoperative comfort of patients in the modified stent group was higher.In the modified stent group,the hospital stay and total hospital stay were shorter[3.0(2.0,5.0)vs 7.0(3.0,14 75),Z=-3.997,P<0.001;(8.95±4.42 vs 11.02±5 27,t=2.317,P=0.022)],the time of first eating and drinking after operation was earlier than that of naso-biliary drainage group((27.6 ± 12.6)h vs(34.3 ± 7.0)h,t=3.579,P=0.001;(7.1±2.3)h vs(10.2±4.7)h,t=4.604,P<0.001]。In the modified stent group,the rate of stent detachment was 83.05%,and there were no complications such as stent obstruction,displacement,rupture,perforation and infection.There was no statistical difference in the overall complication rate between the two groups(13/59 vs 20/60,χ2=1.895,P=0.169).Conclusions:After removing bile duct stones by ERCP,the 7Fr modif ed single pigtail plastic stent of pancreatic duct removed the lateral anchoring structure was used for biliary drainage,which has the effect that of nasobiliary duct drainage.It can shorten the length of postoperative hospitalization,improve the postoperative comfort of patients,accelerate the recovery of patients,and has a high spontaneous dislodgement rate of the stent.The clinical application is safe and effective.