High-risk factors for cholangitis after endoscopic sphincterotomy / 临床肝胆病杂志

ABSTRACT

Objective To investigate the high-risk factors for cholangitis after endoscopic sphincterotomy (EST), and to provide a reference for clinical prevention and treatment.Methods A total of 196 patients who underwent EST in our hospital from June 2013 to January 2016 were enrolled, among whom 31 experienced cholangitis after EST (infection group) and 165 had no cholangitis (control group).Related factors were analyzed for both groups.The t-test was used for comparison of continuous data between groups;the chi-square test was used for comparison of categorical data between groups, and a multivariate non-conditional logistic regression analysis was performed for variables with statistical significance.Results The univariate analysis showed that there were significant differences between the two groups in the past history of biliary tract surgery [8 (25.81%) vs 10 (6.06%), χ2=12.200, P=0.000 5], number of common bile duct stones (2.8±0.5 vs 2.2±0.6, t=5.234, P=0.000 5), gallstones complicated by cholecystitis [8 (25.81%) vs 13 (7.88%), χ2=6.994, P=0.000 4], intrahepatic bile duct stones [6 (19.35%) vs 8 (4.85%), χ2=8.280, P=0.004 0], time of operation (35.6±5.8 min vs 27.1±6.2 min, t=7.072, P=0.000 4), presence or absence of lithotripsy [10 (32.26%) vs 15 (9.09%), χ2=10.591, P=0.000 1], postoperative pneumobilia [12(60.00%) vs 16 (21.82%), χ2=17.940, P=0.000 2], and duration of the use of antibiotics (3.6±0.7 d vs 4.5±0.8 d, t=5.854, P=0.000 6).The multivariate non-conditional logistic regression analysis showed that past history of biliary tract surgery [OR (95%CI)=1.962 (1.156-3.658), P=0.024], number of common bile duct stones [OR (95%CI)=2.632 (1.366-5.013), P=0.021], intrahepatic bile duct stones [OR (95%CI)=2.976 (1.482-5.536), P=0.024], time of operation [OR (95%CI)=4.859 (2.513-8.622), P=0.006], postoperative pneumobilia [OR (95%CI)=5.326 (2.633-10.524), P=0.005], and duration of the use of antibiotics [OR (95%CI)=0.565 (0.263-0.895), P=0.009] were independent risk factors for cholangitis after EST.Conclusion Positive intervention of related risk factors for cholangitis after EST has important clinical significance in the prevention of cholangitis after EST.