[Analysis of related factors for intestinal contents refluxing into the bile duct after endoscopic retrograde biliary drainage].

Objective: To analyze the related factors for intestinal contents refluxing into the biliary tract following endoscopic retrograde biliary drainage (ERBD). Methods: A total of 620 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) to remove biliary stents and perform biliary tract cleaning at the Shanghai East Hospital Gallstone Disease Center from March 2019 to October 2024 were included in this study. Patients were divided into a case group and a control group based on the presence or absence of chyme-fibrin reflux into the biliary tract. Clinical data were collected for all patients, and univariate and multivariate logistic regression analyses were performed to identify related factors for intestinal contents reflux into the biliary tract. Results: A total of 620 patients were included: 397 in the control group, aged 61.0 (51.0, 71.0) years, with 198 males; and 223 in the case group, aged 62.0 (51.0, 70.0) years, with 89 males. The control group had a longer duration of biliary stent placement [3.0 (2.1, 3.5) vs 2.6 (1.8, 3.2) months], a higher proportion of male patients [49.9% (198/397) vs 39.9% (89/223)], history of ERCP procedures [16.4% (65/397) vs 10.3% (23/223)], and hypertension [36.0% (143/397) vs 26.5% (59/223)] compared with the case group (all P>0.05). The proportion of pancreaticobiliary maljunction (PBM)in the case group was higher than that in the control group [10.8% (24/223) vs 4.8% (19/397), P=0.005]. The incidence of endoscopic sphincterotomy (EST) [82.5% (184/223) vs 75.3% (299/397)] and endoscopic papillary balloon dilatation (EPBD) [94.5% (207/223) vs 87.1% (343/397)] was higher in the case group than in the control group (both P<0.05); the total number of biliary stents placed was higher in the control group (10.1% vs 4.9%) than in the case group (P=0.023). Multivariate logistic regression analysis identified PBM (OR=2.00, 95%CI: 1.05-3.81),female gender (OR=1.45, 95%CI: 1.02-2.07), duration of biliary stent placement (OR=0.87, 95%CI: 0.80-0.96) and hypertension (OR=0.61, 95%CI: 0.42-0.89) as related factors for post-ERBD intestinal contents reflux into the biliary tract. Conclusion: Female gender and PBM are related factors for post-ERBD intestinal contents reflux into the biliary tract.