Factors influencing stent occlusion after endoscopic placement of a biliary plastic stent in high-risk elderly patients with large common bile duct stones
Objective To identify factors that influence stent obstruction after endoscopic placement of a biliary plastic stent in high-risk elderly patients with large common bile duct stones.Methods The data of high-risk elderly patients who received endoscopic placement of a biliary plastic stent for large common bile duct stones from January 2016 to March 2024 were retrospectively analyzed.All patients were followed up for 3 months and received a second ERCP within 3 months.The patients were divided into obstruction group and patency group.The baseline data,laboratory test results,stone size,type of stent,diameter of stent and periampullary diverticula(PAD)were compared between two groups.The multivariate logistic regression analysis was conducted to identify factors that influence stent occlusion.Results A total of 111 patients were enrolled,of which 28 were in the obstruction group and 83 in the patency group,with a stent occlusion rate of 25.23%.White blood cell(WBC),Alanine transaminase(ALT),diameter of stent and PAD were found to be significant on univariate analysis.The multivariate logistic regression analysis indicated that WBC(OR 1.209,95%CI 1.074-1.361),diameter of stent(OR 0.279,95%CI 0.088-0.887)and PAD(OR 3.396,95%CI 1.077-10.710)were independent risk factors for stent occlusion.Conclusion Patients with preoperative elevated WBC and periampullary diverticula have a high risk of stent occlusion,and stents larger in diameter exhibit later onset of clogging.
Elderly patientHigh-riskCommon bile duct stoneBiliary plastic stentStent occlusion