Preliminary Analysis Of Risk Factors Of Complications After PTCD For Hepatic Hydatid Complicated With Obstructive Jaundicetcd

Objective: To investigate the risk factors of postoperative complications of hepatic hydatid complicated with obstructive jaundice after PTCD,and to study its feasibility and safety,so as to guide clinical work.Methods: The clinical data of 100 patients with hepatic hydatidcomplicated with obstructive jaundice who underwent PTCD in Qinghai University Affiliated Hospital from June 2015 to October 2021 were collected.The general data of the patients on admission were compared,and the preoperative related indicators: alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),alkaline phosphatase(ALP),γ-glutamyl transpeptidase(GGT),albumin(ALB),Child-Pugh grade and prothrombin time(PT),etc.,to observe the incidence of complications after PTCD,and use univariate and multivariate Logistic regression to analyze the complications of hepatic hydatid.Risk factors for complications in patients with obstructive jaundice after PTCD.Result:(1)A total of 41 patients had postoperative complications,including 15 cases of biliary tract infection,16 cases of biliary tract hemorrhage,6 cases of biliary leakage,and 4 cases of duct obstruction.(2)There were differences in the site of obstruction,drainage time(≥ 30 days),Child-Pugh grade,ALT,and ALP in patients with different biliary tract infections(P<0.05).Child-Pugh classification was an independent risk factor for biliary tract infection(OR=3.963,P=0.047;OR=4.096,P=0.035);PT was different in different patients with biliary tract bleeding(P<0.05).Multivariate Logistic regression analysis,PT It was an independent risk factor for biliary bleeding(OR=1.045,P=0.010);there were differences in the site of liver puncture in different patients with biliary leakage(P<0.05).Multivariate Logistic regression analysis showed that the site of liver puncture(left liver)was the most common cause of biliary leakage.Independent risk factors(OR=0.051,P=0.011);there were differences in the obstruction site,liver puncture site,biliary tract infection,and average daily bile drainage volume in patients with different catheter obstruction(P<0.05).High position,liver puncture site(right liver),and biliary tract infection were independent risk factors for duct obstruction(OR=2.589,P=0.001;OR=2.576,P=0.020;OR=3.758,P=0.005).Conclusion: Biliary tract infection,biliary tract hemorrhage,bile leakage,and duct obstruction are complications of hepatic hydatid disease complicated with obstructive jaundice after PTCD.Drainage time(≥30days)and Child-Pugh classification are independent risk factors for biliary tract infection after PTCD;PT prolongation is an independent risk factor for biliary bleeding after PTCD;liver puncture site(left liver)is the independent risk factor for biliary leakage after PTCD Obstruction site(high),liver puncture site(right liver),and biliary tract infection were independent risk factors for catheter obstruction after PTCD.