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ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 8
Aug.  2023
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Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(8): 1911-1918

Safety and efficacy of modified pancreatic duct stent in biliary drainage after complete bile duct stone removal by endoscopic retrograde cholangiopancreatography

DOI: 10.3969/j.issn.1001-5256.2023.08.021
  • 1.

    College of Clinical Medicine, Guizhou Medical University, Guiyang 550004, China

  • 2.

    Department of Hepatobiliary Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China

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  • Corresponding author: HAN Min, 409582096@qq.com (ORCID: 0000-0001-7218-5276)
  • Received Date: 2022-12-12
  • Accepted Date: 2023-02-07
  • Published Date: 2023-08-20
    Abstract
  •   Objective  To investigate the clinical application value of modified 7Fr pancreatic duct plastic stent in biliary drainage.  Methods  Clinical data were collected from 121 patients with choledocholithiasis who underwent endoscopic retrograde cholangiopancreatography (ERCP) lithotomy and biliary drainage in Department of Hepatobiliary Surgery, The Affiliated Hospital of Guizhou Medical University, from April 2021 to June 2022, and according to the method for postoperative biliary drainage, they were divided into modified stent group with 59 patients and nasobiliary drainage group with 60 patients. The patients in the modified stent group received drainage with the modified 7Fr pancreatic duct plastic stent, and those in the nasobiliary drainage group received nasobiliary drainage. A retrospective analysis was performed for their clinical data, and stent dislodgement was observed for the modified stent group. The two groups were compared in terms of clinical outcome, postoperative comfort, and postoperative complications. The independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups.  Results  Both groups achieved a stone clearance rate of 100%. There were significant differences between the two groups in the length of postoperative hospital stay and the total length of hospital stay (t=-3.997 and 2.317, both P < 0.05). After treatment, both groups had significant reductions in total bilirubin (TBil), direct bilirubin (DBil), indirect bilirubin (IBil), alkaline phosphatase (ALP), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (all P < 0.05), and there were no significant differences between the two groups in the changes in TBil, DBil, IBil, ALP, alanine aminotransferase, and AST after treatment (all P>0.05). Also, no significant differences were observed between the two groups in the changes in biochemical parameters after treatment (all P>0.05). There were significant differences between the two groups in comfort score within 24 hours after surgery and the time to first eating and drinking after surgery (t=2.001, 3.579, and 4.604, all P < 0.05). There were no significant differences in complications between the two groups (all P>0.05). In the modified stent group, the rate of spontaneous stent dislodgement was 83.05%, and there were no complications such as stent occlusion, displacement, rupture, perforation, and infection.  Conclusion  After complete bile duct stone removal by ERCP, biliary drainage using the modified 7Fr pancreatic duct plastic stent has a similar effect to nasobiliary drainage and can shorten the length of postoperative hospital stay, improve postoperative comfort, and accelerate postoperative recovery, with a relatively high spontaneous dislodgement rate. Therefore, it is safe and effective in clinical practice.

     

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