Influencing factors for stent obstruction after endoscopic retrograde biliary drainage in patients with refractory common bile duct stones

Objective To investigate the influencing factors for stent obstruction after endoscopic retrograde biliary drainage(ERBD) forrefractory common bile duct stones.Methods A total of 126 patients who underwent ERBD for refractory common bile duct stones inRenmin Hospital of Wuhan University from January 2014 to May 2019 and were readmitted for stent removal at 6 months after surgery wereenrolled, and according to the condition of stent removal, they were divided into obstruction group and unobstructed group. General data andrelated indices were compared between the two groups. The independent samplest-test was used for comparison of normally distributed con-tinuous data between groups, and the Mann-WhitneyUtest was used for comparison of non-normally distributed continuous data betweengroups; the chi-square test was used for comparison of categorical data between groups; a multivariate logistic regression analysis was usedto investigate the influencing factors for stent obstruction after surgery.Results Among the 126 patients, 28 were found to have stent ob-struction during removal, with a stent obstruction rate of 22. 2%. The univariate analysis showed that there were significant differences be-tween the two groups in white blood cell count(WBC), percentage of neutrophils(Neu%), alkaline phosphatase(ALP), gamma-glu-tamyl transpeptidase, leucine aminopeptidase, endoscopic sphincterotomy(EST), infection, aspirin, and stent type(allP< 0. 05). Themultivariate logistic regression analysis showed that WBC[OR(95% CI):1. 232(1. 033-1. 470)], Neu% [OR(95% CI):1. 263(1. 021-1. 562)], ALP[OR(95% CI):1. 013(1. 004-1. 022)], EST[ OR(95% CI):5. 890(1. 114-31. 139)], infection[ OR(95% CI):17. 317(1. 349-222. 349)], and stent type[OR(95% CI):0. 144(0. 022-0. 937)] were independent influencing factors for postopera-tive stent occlusion(allP< 0. 05).Conclusion Patients with elevated WBC/Neu%/ALP, intraoperative EST, and preoperative secondaryinfection have a high risk of postoperative stent obstruction, and close follow-up and early prevention should be performed for such patients.The double pigtail stent can effectively reduce the rate of postoperative stent obstruction.