Risk factors for duodenal injury caused by plastic stent malposition in patients with bile duct stenosis
10.3760/cma.j.cn321463-20221014-00423
- VernacularTitle:胆管狭窄患者塑料支架移位致十二指肠损伤的危险因素研究
- Author:
Sile CHENG
1
;
Hongzhang SHEN
;
Lu XIE
;
Weigang GU
;
Xiaofeng ZHANG
Author Information
1. 浙江大学医学院附属杭州市第一人民医院消化内科 杭州市消化病研究所 浙江省中西医结合胆胰疾病重点实验室，杭州310006
- Keywords:
Stents;
Bile ducts;
Duodenum;
Risk factors;
Malposition;
Injury
- From:
Chinese Journal of Digestive Endoscopy
2023;40(9):724-728
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the risk factors for duodenal injury caused by malposition of plastic bile duct stent for the treatment of biliary stricture.Methods:Data of 1 408 patients with biliary stricture (2 607 procedures of plastic stent placement) who received plastic stent placement in Hangzhou First People's Hospital from January 2017 to December 2021 were retrospectively analyzed and duodenal injury caused by bile duct stent malposition after placement was recorded. The patients were divided into two groups: the malposition injury group ( n=23 procedures) and the non-malposition injury group ( n=2 584 procedures). The differences in the baseline data and procedure-related condition between the malposition injury group and the non-malposition injury group were compared, and the independent risk factors for duodenal injury caused by bile duct plastic stent malposition were studied by using logistic regression analysis. Results:A total of 2 607 procedures of plastic stent placement were performed in 1 408 patients with biliary stricture, and 23 cases of duodenal injury were caused by stent malposition. Logistic regression analysis revealed that a history of gastrointestinal surgery ( OR=4.278, 95% CI: 1.332-13.737, P=0.015), a history of endoscopic sphincterotomy (EST) ( OR=8.128, 95% CI: 2.382-27.738, P=0.001), and high-level bile duct stenosis ( OR=4.457, 95% CI: 1.722-11.539, P=0.002), plastic stents with a length≥ 7 cm ( OR=4.701, 95% CI: 1.708-12.938, P=0.003) and Christmas tree-shaped stent ( OR=6.890, 95% CI: 1.540-30.830, P=0.012) were independent risk factors for duodenal injury caused by bile duct plastic stent malposition. Conclusion:High-level bile duct stenosis, the use of plastic stents with a length≥ 7 cm and Christmas tree-shaped stent, a history of gastrointestinal surgery, and a history of EST could increase the risk of duodenal injury caused by bile duct plastic stent malposition in patients with bile duct stenosis.
