Comparative Study on Nosocomial Biliary Tract Infection Rate Between Biliary Stent Loaded with Radioactive 125I Seeds and Conventional Biliary Stent in the Treatment of Distal Malignant Biliary Obstruction

Background: The purpose of this prospective randomized study was to compare the nosocomial biliary tract infection rate of biliary stent implantation with a biliary stent loaded with radioactive I-125 seeds (radioactive biliary stent, RBS) and conventional biliary stent (CBS); additionally, to preliminary discuss the causes of postoperative cholangitis. Moreover, the results will provide clinical evidence for the prevention of postoperative biliary tract infection. Materials and Methods: We prospectively analyzed the nosocomial infection rate of the distal malignant biliary obstruction (MBO) treatment by stent implantation with RBS and CBS. All MBO patients who initially visited our tertiary hospital between July 2015 and December 2019 (n= 196) were evaluated, enrolled, and randomly divided into 2 groups, RBS (n=97) and CBS (n=99) group. chi(2) test was used to evaluate the categorical data, and t test was used to evaluate the numerical data. Results: Our analysis of the study showed the incidence of postoperative infections of a biliary tract of the RBS group (23.7%) was significantly higher than the CBS group (11.1%). The difference was statistically significant (chi(2)=5.425, P=0.020). Our study also showed the most common pathogenic bacteria after surgery was Escherichia coli (26.5%). Conclusion: Treatment for distal MBO with biliary stent loaded with radioactive I-125 seeds had a higher nosocomial infection rate, and the most common pathogenic bacteria was E coli., Supplemental Digital Content 1,