Analysis of factors associated with T-tube sinus tract formation after common bile duct exploration and T-tube drainage

Objective To 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. Methods The 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. Results T-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]. Conclusions The 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