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©The Author(s) 2025.
World J Gastrointest Surg. Mar 27, 2025; 17(3): 99425
Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.99425
Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.99425
Table 1 Baseline characteristics of 94 patients with bile duct leaks, n (%)
| Characteristics | Overall (n = 94) | < 3 weeks (n = 50) | > 3 weeks (n = 44) | P value |
| Basic demographics | ||||
| Sex | - | - | - | 0.392 |
| Female | 28 (29.8) | 13 (26) | 15 (34.1) | - |
| Male | 66 (70.2) | 37 (74) | 29 (65.9) | - |
| Age, years, mean ± SD | 52.5 ± 12.9 | 54.1 ± 13.3 | 50.6 ± 12.4 | 0.192 |
| BMI, mean ± SD | 23.1 ± 3.4 | 23.1 ± 3.2 | 23.1 ± 3.7 | 0.830 |
| CCI, (Q1, Q3) | 3 (1, 4) | 2 (1, 4) | 3 (1, 5) | 0.163 |
| Laboratory test within 3 days before ERCP | ||||
| WBC, × 109/L (Q1, Q3) | 8.2 (6.3, 16.9) | 8.5 (7.2, 11.6) | 8.1(6.0, 12.8) | 0.909 |
| ALT, U/L (Q1, Q3) | 36.4 (25.9, 80.6) | 32.3 (25.9, 57.3) | 38 (24.7, 98.0) | 0.480 |
| Tbil, μmol/L (Q1, Q3) | 20.2 (12.3, 38.8) | 20.5 (13.5, 60.0) | 18.5 (11.7, 36.5) | 0.191 |
| Albumin, g/L, mean ± SD | 35.2 ± 5.9 | 35.4 ± 6.8 | 35.0 ± 4.8 | 0.728 |
| Creatinine, μmol/L (Q1, Q3) | 58.4 (48.9, 71.7) | 57.2 (46.6, 71.1) | 59.2 (46.4, 71.2) | 0.796 |
| Etiology of BDLs | - | - | - | 0.307 |
| Cholecystectomy | 65 (69.1) | 39 (78.0) | 26 (59.1) | - |
| Liver transplantation | 13 (13.8) | 6 (12.0) | 7 (15.9) | - |
| Partial hepatectomy | 8 (8.5) | 3 (6.0) | 5 (11.4) | - |
| Trauma | 4 (4.3) | 1 (2.0) | 3 (6.8) | - |
| Others | 4 (4.3) | 1 (2.0) | 3 (6.8) | - |
| Treatment methods | - | - | - | 0.149 |
| Plastic stent | 52 (55.3) | 28 (56) | 32 (64) | - |
| 5 Fr | 2 (2.1) | 0 (0) | 2 (4.5) | - |
| 7 Fr | 3 (3.2) | 3 (6.0) | 0 (0) | - |
| 8.5 Fr | 12 (12.8) | 5 (10.0) | 7 (15.9) | - |
| 10 Fr | 35 (37.2) | 20 (40.0) | 23 (52.3) | - |
| Metal stent (10 mm) | 3 (3.2) | 2 (4.0) | 1 (2.3) | - |
| Nasobiliary drainage tube | 31 (33.0) | 20 (40.0) | 11 (25.0) | - |
| Procedure characteristics | ||||
| Location of BDLs | - | - | - | 0.488 |
| Cystic duct | 53 (56.4) | 29 (58.0) | 24 (54.5) | - |
| Common bile duct | 20 (21.3) | 10 (20.0) | 10 (22.7) | - |
| Hilar bile duct | 12 (12.8) | 8 (16.0) | 4 (9.1) | - |
| Intrahepatic bile duct | 9 (9.6) | 3 (6.0) | 6 (13.6) | - |
| Abdominal drainage | 76 (80.9) | 42 (84.0) | 34 (77.3) | 0.410 |
| Strasberg classification | - | - | - | 0.259 |
| A | 38 (40.4) | 24 (48.0) | 14 (31.8) | - |
| C | 11 (11.7) | 5 (10.0) | 6 (13.6) | - |
| D | 32 (34.0) | 13 (26.0) | 19 (43.2) | - |
| E1 | 5 (5.3) | 4 (8.0) | 1 (2.3) | - |
| E2 | 8 (8.5) | 4 (8.0) | 4 (9.1) | - |
Table 2 Success rate and biliary stricture associated with the timing of endoscopic retrograde cholangiopancreatography
| Timing | Success (%) | OR | P value | Biliary stricture (%) | OR | P value | ||
| Yes | No | Yes | No | |||||
| < 3, n = 6 | 5 (83.3) | 1 (16.7) | 0.946 (0.103-8.725) | 0.961 | 2 (33.3) | 4 (66.7) | 0.130 (0.195-6.545) | 0.892 |
| > 3, n = 88 | 74 (84.1) | 14 (15.9) | - | - | 27 (30.7) | 61 (69.3) | - | - |
| < 7, n = 18 | 16 (88.9) | 2 (11.1) | 1.651 (0.338-8.068) | 0.536 | 3 (16.7) | 15 (83.3) | 0.385 (0.102-1.450) | 0.158 |
| > 7, n = 76 | 63 (82.9) | 13 (17.1) | - | - | 26 (34.2) | 50 (65.8) | - | - |
| < 14, n = 32 | 28 (87.5) | 4 (12.5) | 1.510 (0.440-5.185) | 0.513 | 4 (12.5) | 28 (87.5) | 0.211 (0.066-0.677) | 0.009 |
| > 14, n = 62 | 51 (82.3) | 11 (17.7) | - | - | 25 (40.3) | 37 (59.7) | - | - |
| < 21, n = 50 | 46 (92.0) | 4 (8.0) | 3.833 (1.122-13.097) | 0.032 | 9 (18.0) | 41 (82.0) | 0.263 (0.103-0.670) | 0.005 |
| > 21, n = 44 | 33 (75.0) | 11 (25.0) | - | - | 20 (45.5) | 24 (54.5) | - | - |
Table 3 Univariable and multivariable analysis of factors associated with successful endoscopic retrograde cholangiopancreatography, n (%)
| Variable | Univariable analysis | Multivariable analysis | ||||
| Success (n = 79) | Failure (n = 15) | P value | OR | 95%CI | P value | |
| Basic demographics | ||||||
| Sex, female | 24 (30.4) | 4 (26.7) | 0.773 | - | - | - |
| Age, years, mean ± SD | 52.8 ± 12.7 | 51.0 ± 14.6 | 0.638 | - | - | - |
| BMI, mean ± SD | 23.4 ± 3.4 | 21.5 ± 3.1 | 0.049 | 0.814 | 0.653-1.014 | 0.067 |
| CCI, (Q1, Q3) | 2.5 (1, 4) | 3.0 (2, 7) | 0.031 | 0.864 | 0.704-1.062 | 0.164 |
| Laboratory test within 3 days before ERCP | ||||||
| WBC, × 109/L, mean ± SD | 9.4 ± 4.3 | 10.4 ± 5.1 | 0.390 | - | - | - |
| ALT, U/L (Q1, Q3) | 36.1 (25.9, 81.2) | 39.6 (22.8, 82.0) | 0.812 | - | - | - |
| Tbil, μmol/L (Q1, Q3) | 19.3 (12.1, 39.4) | 34.0 (12.6, 80.0) | 0.715 | - | - | - |
| Albumin, g/L, mean ± SD | 35.3 ± 6.0 | 34.6 ± 5.6 | 0.659 | - | - | - |
| Creatinine, μmol/L (Q1, Q3) | 58.0 (47.0, 69.0) | 59.3 (52.0, 99.0) | 0.196 | - | - | - |
| Etiology of BDLs | - | - | 0.126 | - | - | - |
| Cholecystectomy | 58 (73.4) | 7 (46.7) | - | - | - | - |
| Liver transplantation | 9 (11.4) | 4 (26.7) | - | - | - | - |
| Partial hepatectomy | 7 (8.9) | 1 (6.7) | - | - | - | - |
| Trauma | 2 (2.5) | 2 (13.3) | - | - | - | - |
| Others | 3 (3.8) | 1 (6.7) | - | - | - | - |
| Characteristics of different methods | -- | - | 0.326 | - | - | - |
| Plastic stent | 50 (63.3) | 10 (66.7) | - | - | - | - |
| Metal stent (10 mm) | 2 (2.5) | 1 (6.7) | - | - | - | - |
| Nasobiliary drainage tube | 27 (34.2) | 4 (26.7) | - | - | - | - |
| Location of BDLs, cystic duct | 51 (64.6) | 2 (13.3) | 0.002 | 12.219 | 2.317-64.433 | 0.003 |
| Biliary stricture | 23 (29.1) | 6 (40.0) | 0.403 | - | - | - |
| Performing ERCP within 3 weeks | 46 (58.2) | 4 (26.7) | 0.032 | 4.168 | 1.031-16.841 | 0.045 |
| Abdominal drainage | 64 (81.0) | 12 (15.8) | 0.938 | - | - | - |
Table 4 Univariable and multivariable analysis of variables associated with biliary stricture, n (%)
| Variable | Univariable analysis | Multivariable analysis | |||||
| Biliary stricture (n = 29) | No biliary stricture (n = 65) | P value | OR | 95%CI | P value | ||
| Basic demographics | |||||||
| Sex, female | 12 (41.4) | 16 (24.6) | 0.104 | - | - | - | |
| Age, years, mean ± SD | 54.14 ± 13.3 | 50.6 ± 12.39 | 0.585 | - | - | - | |
| BMI, mean ± SD | 23.1 ± 3.2 | 23.1 ± 3.7 | 0.316 | - | - | - | |
| CCI, (Q1, Q3) | 2 (1, 4) | 3 (1, 5) | 0.021 | 1.109 | 0.918-1.338 | 0.217 | |
| Laboratory test within 3 days before ERCP | |||||||
| WBC, × 109/L (Q1, Q3) | 8.4 (3, 4) | 10.0 (4, 8) | 0.110 | - | - | - | |
| ALT, U/L (Q1, Q3) | 32.3 (25.9, 57.3) | 38 (24.7, 98.0) | 0.245 | - | - | - | |
| Tbil, μmol/L (Q1, Q3) | 20.5 (13.5, 60.0) | 18.6 (11.7, 36.5) | 0.327 | - | - | - | |
| Albumin, g/L, mean ± SD | 35.4 ± 6.8 | 35.0 ± 4.8 | 0.341 | - | - | - | |
| Creatinine, μmol/L (Q1, Q3) | 57.2 (50.4, 73.8) | 59.2 (46.4, 71.2) | 0.916 | - | - | - | |
| Etiology of BDLs, liver transplantation | 7 (24.1) | 6 (9.2) | 0.053 | 2.657 | 0.562-12.551 | 0.284 | |
| Location of BDLs | - | - | 0.438 | - | - | - | |
| Cystic duct | 14 (48.3) | 39 (60.0) | - | - | - | - | |
| Common bile duct | 9 (31.0) | 11 (16.9) | - | - | - | - | |
| Hilar bile duct | 4 (13.8) | 8 (12.3) | - | - | - | - | |
| Intrahepatic bile duct | 2 (6.9) | 7 (10.8) | - | - | - | - | |
| Performing ERCP within 3 weeks | 9 (31.0) | 41 (63.1) | 0.005 | 0.256 | 0.096-0.683 | 0.007 | |
- Citation: Chen DX, Fang KX, Chen SX, Hou SL, Wen GH, Yang HK, Shi DP, Lu QX, Zhai YQ, Li MY. Optimal timing of endoscopic biliary drainage for bile duct leaks: A multicenter, retrospective, clinical study. World J Gastrointest Surg 2025; 17(3): 99425
- URL: https://www.wjgnet.com/1948-9366/full/v17/i3/99425.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v17.i3.99425