Factors Inf lfluenced with Periductal Fibrosis of Hepatobiliary Tract in Wangtong Sub-District, Phakdichumphon District, Chaiyaphum Province

Abstract

The objectives of this descriptive study were to survey prevalence and identify risk factors
inflf luenced with periductal fif ibrosis that was the pathological changed of hepatobiliary tract due to chronic
inflf lammation make bile duct wall thickening and may developed to Cholangiocarcinoma in the future.
The samples were the population aged 40 and over in Wangtong sub-district, Phakdichumphon
district, Chaiyaphum province. The sample sizes were calculated from the Wayne’s formula to
255 samples. During the collection of ultrasound examination, people were more interested in asking
for ultrasound examination rather than calculated. 755 samples were collected accounting for 296%
of the calculated samples. The research tools were questionnaire that consists of two parts, the general
information data and ultrasound examination data. The questionnaires were checked the content
validity by qualif ified experts. Ultrasound examinations were done by physicians who have been trained
in screening ultrasound course. Analysis of data used computer program, general information data
and ultrasound examination data were analyzed by descriptive statistics frequency and percentage,
analysis data factors inflf luenced with periductal f ibrosis used inference statistics multiple logistic
regression with backward elimination method and present size of relation with adjusted odds ratio
(ORadj) and 95%CI. The results of the study showed that ultrasound examination samples were found
periductal fif ibrosis (PDF) = 28.2% divided to PDF1=17.0% PDF2= 11.0% PDF3=0.2%, found
liver mass 11 cases (1.5%) and dilated bile duct 4 cases (0.5%), Transfer to further ultrasound
and CT scan diagnosis at Chaiyaphum Hospital 8 cases (1.1%). The investigation results found
Hepatocellular carcinoma 1 case (0.132%), a male patient 71 years old had surgical treatment
at Chaiyaphum province hospital and Cholangiocarcinoma 1 case, A male patient 68 years old had
refer to Khonkaen province hospital. The study found that factors inf luenced with periductal fibrosis
included history eat raw fif ish or uncooked pickled fif ish (ORadj=5.87; 95%CI=1.38-24.96, p=0.017)
smoking (ORadj=1.62; 95%CI=1.08-2.43, p=0.020), alcohol drinking (ORadj=1.51; 95%CI=
1.05-2.17, p=0.026), had family history of Cholangiocarcinoma (ORadj=2.06; 95%CI=
1.07-3.95, p=0.031). The study results show that Wangtong sub-district, Phakdichumphon district,
Chaiyaphum province was high risk area for Periductal Fibrosis of Hepatobiliary tract, there should
be long term policy for disease prevention and control, increased publicity and access to stool
examination and screening ultrasound for high risk population, campaign to stop eat raw fif ish or uncooked
pickled fif ish together with quit smoking and stop alcohol drinking, corrected understand about Praziquantel
used and increased screening in people who had family history of Cholangiocarcinoma.