Original Article
Analysis of factors associated with T-tube sinus tract formation after common bile duct exploration and T-tube drainage
Jianchu Wang, Jian Pu, Cunchuan Wang, Rihai Ma, Yuan Lu, Chenyi Zhuo, Yumin Lu
Published 2015-02-20
Cite as Chin J Dig Surg, 2015, 14(2): 141-144. DOI: 10.3760/cma.j.issn.1673-9752.2015.02.011
Abstract
ObjectiveTo explore the risk factors affecting T-tube sinus tract formation after common bile duct exploration and T-tube drainage by spiral computed tomography (SCT) examination.
MethodsThe clinical data of 465 patients undergoing common bile duct exploration and T-tube drainage at the Affiliated Hospital of Youjiang Medical College for Nationalities from May 2011 to December 2013 were retrospectively analyzed. The residual stones and biliary stricture were detected by T-tube cholangiography, and the T-tube sinus tract formation in all the patients was detected by SCT examination at postoperative week 2. The factors affecting sinus tract formation were analyzed, including gender, age, albumin (Alb) , C-reactive protein, alanine transaminase (ALT) , total bilirubin (TBil) , hemoglobin (Hb) , surgical method, effusion around T tube, reoperation, diabetes. Univariate analysis was done using the chi-square test. Multivariate analysis was done using the Logistic regression.
ResultsT-tubes of 465 patients were clear without residual stones. T-tube in the 397 patients was removed when the sinus tract formation was confirmed by CT examination at postoperative week 2. T-tubes in other patients were removed when the sinus tract formation was detected by CT reexamination at postoperative week 4. In univariate analysis, Alb, surgery method, effusion around T-tube and diabetes were important factors affecting T-tube sinus tract formation (χ2=50. 750, 7. 671, 19. 022, 15. 373, P <0.05) . Alb <30 g/ L, laparoscopic surgery, effusion around T-tube and diabetes were independent risk factors affecting T-tube sinus tract formation in multivariate analysis[Odds ratio =1. 135, 0. 493, 0. 262, 0. 363; 95% confidence interval: 1. 061-1. 214, 0. 280-0. 865, 0. 104-0. 658, 0. 156-0. 843, P <0.05].
ConclusionsThe T-tube removal is determined according to the sinus tract formation by CT examination at week 2 after common bile duct exploration and T-tube drainage. Alb <30 g/ L, laparoscopic surgery, effusion around T-tube and diabetes are independent risk factors affecting T-tube sinus tract formation.
Key words:
Biliary diseases; Common bile duct drainage; T tube sinus tract; Regression analysis
Contributor Information
Jianchu Wang
Department of Hepatobiliary Surgery, Affiliated Hospital of Youjiang Medical College for Nationalities, Baise 533000, China
Jian Pu
Cunchuan Wang
Rihai Ma
Yuan Lu
Chenyi Zhuo
Yumin Lu
