فهرست نشریات علمی دسترسی آزاد ایران

Background: Early biliary infection (EBI) is a significant and prevalent complication following percutaneous transhepatic biliary stenting, especially in cases involving the use of 125 I particle stents for malignant biliary obstruction (MBO). Objectives: This study aims to uncover potential risk factors contributing to EBI post-implantation in this patient group. Results: Out of the 178 patients, 35 (19.7%) developed EBI within 30 days post-implantation. Every EBI case was accompanied by a positive bile culture. Notably, patients with EBI more frequently had diabetes [odds ratio (OR), 3.329; 95% confidence interval (CI), 1.129 - 9.819; regression coefficient (B) = 1.203; P = 0.029], gallstones in the gallbladder or bile ducts (OR, 3.459; 95% CI, 1.060 - 11.283; B = 1.241; P = 0.040), higher level of biliary obstruction (OR, 3.008; 95% CI, 1.243 - 7.280; B = 1.101; P = 0.015), intraoperative biliary bleeding (OR, 5.416; 95% CI, 1.569 - 18.696; B = 1.689; P = 0.008), and postoperative intrahepatic pneumobilia (OR, 2.655; 95% CI, 1.108 - 6.362; B = 0.976; P = 0.029) compared to those without EBI. These factors were positively correlated with EBI development post-implantation. Conversely, the duration from percutaneous transhepatic biliary drainage (PTBD) to 125 I stent implantation was longer in patients without EBI (OR, 0.966; 95% CI, 0.940 - 0.992; B = - 0.035; P = 0.012), suggesting a negative association with EBI occurrence. Conclusion: This study identifies diabetes, gallstones in the gallbladder or bile ducts, high-level obstruction, intraoperative biliary bleeding, and postoperative intrahepatic pneumobilia as significant risk factors for EBI. Additionally, a longer interval from PTBD to 125 I stent implantation emerges as a protective factor against EBI in patients with MBO undergoing 125 I particle stent implantation. These risk factors can offer guidance to minimize post- 125 I particle stent implantation biliary infection, thereby shortening hospitalization for affected patients.