Internal vs oral bile reinfusion for hepatic recovery after percutaneous transhepatic cholangiodrainage

Figure 1 Temporal changes in total bilirubin levels. Changes in serum total bilirubin levels over time in patients receiving internal bile reinfusion (observation group, blue line with circles) vs oral bile reinfusion (control group, red dashed line with squares). The observation group demonstrated significantly greater reduction in bilirubin at all time points following initiation of reinfusion (P = 0.001 at 1 week; P < 0.001 at 2 weeks and 4 weeks). Error bars represent standard deviation. ^cP < 0.001 between groups.

Figure 2 Multivariate predictors of favorable hepatic function recovery. Forest plot illustrating independent predictors of favorable hepatic function recovery, defined as achieving both total bilirubin < 51 μmol/L and albumin ≥ 35 g/L at 4 weeks post-reinfusion. Internal bile reinfusion emerged as the strongest independent predictor (adjusted odds ratio [OR] = 9.25, 95% confidence interval [CI]: 3.58-23.91; P < 0.001), maintaining robust significance even after controlling for all potential confounders. Other significant independent predictors included baseline bilirubin < 170 μmol/L (adjusted OR = 3.82, 95%CI: 1.45-10.05; P = 0.007), Eastern Cooperative Oncology Group (ECOG) performance status 0-1 (adjusted OR = 3.15, 95%CI: 1.28-7.75; P = 0.012), and age < 65 years (adjusted OR = 2.68, 95%CI: 1.12-6.41; P = 0.027). Primary tumor type did not significantly predict outcomes (P = 0.412). The dashed vertical line represents OR = 1 (no effect). Data point size reflects the relative importance of each predictor.