Analysis of the effect of chemical cholecystectomy on cholecystitis after biliary stent implantation

Abstract

Abstract: Objective To analyze the high-risk factors, characteristics of inflammatory markers, and predictive value of IL-6 and PCT in diagnosing cholecystitis after biliary stent implantation in patients with malignant biliary tract tumors. Methods A retrospective analysis was conducted on the clinical data of 205 patients (including 22 cases of postoperative cholecystitis) who underwent percutaneous biliary stent implantation for malignant obstructive jaundice in our hospital from January 2021 to December 2023. High-risk factors for postoperative cholecystitis were analyzed based on factors such as transaminase and bilirubin levels before and one week after surgery, presence of biliary stones or a history of biliary stones, tumor and stent placement in the lower segment of the common bile duct, and visualization of the gallbladder after intraoperative biliary stent implantation. Compare the differences in CRP, PCT, IL-6, and TNF - α between the two groups, and analyze the predictive value of IL-6 and PCT for their diagnosis. Results One week after surgery, the total bilirubin value in the group with concurrent cholecystitis (235.99 ± 145.22) μmol/L was higher than that in the control group (185.28 ± 131.41) μmol/L. The incidence of concurrent cholecystitis combined with biliary stones or a history of biliary stones was 22.73% higher than that in the control group (9.84%). The incidence of concurrent cholecystitis in patients with tumors or stents located in the lower part of the common bile duct was 68.18% higher than that in the control group (19.67%). Logistic analysis of variables showed that tumors and stents located in the lower part of the common bile duct were the main factors affecting the occurrence of cholecystitis after biliary stent implantation (OR=1.176, P=0.016). The ROC curve results showed that at 14.58 pg The sensitivity and specificity of IL-6 in predicting postoperative cholecystitis after biliary stent implantation were 68.2% and 70.0%, with/mL as the cutoff value; With a cut-off value of 4.21ng/mL, the sensitivity and specificity of PCT in predicting postoperative cholecystitis after biliary stent implantation are 50.0% and 96.7%, respectively; The sensitivity and specificity of the combined prediction of cholecystitis after biliary stent implantation are 67.7% and 90.4%, respectively. Conclusion Tumors and stents located in the lower segment of the common bile duct are the main factors affecting the occurrence of cholecystitis after biliary stent implantation. IL-6 and PCT are valuable in predicting its diagnosis, and their combination can better predict the occurrence of cholecystitis after biliary stent implantation.

Key words: Malignant tumors of the biliary tract, Biliary stent implantation, Cholecystitis, Interlukin-6, Procalcitonin

YANG Xiao-bin, JIANG Jin-quan. Analysis of the effect of chemical cholecystectomy on cholecystitis after biliary stent implantation[J]. Chinese Hepatolgy, 2025, 30(2): 245-248.

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