Benign biliary strictures refractory to standard bilioplasty treated using polydoxanone biodegradable biliary stents: retrospective multicentric data analysis on 107 patients

Mauri, Giovanni; Michelozzi, Caterina; Melchiorre, Fabio; Poretti, Dario; Pedicini, Vittorio; Salvetti, Monica; Criado, Eva; Fagés, Joan Falcó; Gregorio, M.A. de; Laborda, Alicia; Sonfienza, Luca Maria; Cornalba, Gianpaolo; Monfardini, Lorenzo; Pánek, Jiří; Andrasina, Tomas; Giménez, Mariano Eduardo

doi:10.1007/s00330-016-4278-6

Cited by 74 publications

(62 citation statements)

References 24 publications

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“…Our promising findings reflect the correct expansion force needed to keep the stent in place and the controlled degradation profile to maintain the long‐term stricture remodeling effect. Our findings are in line with previously published data on the clinical use of biodegradable polydioxanone biliary stents . The strength of this unique study is the minutely documented follow‐up protocol.…”

Section: Discussionsupporting

confidence: 90%

“…6 Accordingly, the only clinical study on polydioxanone BDBS use in human biliary duct with either postoperative stricture of hepaticojejunal anastomosis or stricture related to chronic pancreatitis presented an 18% recurrence rate in 23 months of follow up. 7 The present study is the first to clinically evaluate the novel endoscopically deployed polydioxanone BDBS in benign biliary strictures. Similar to our earlier finding, 5 technical insertion of the stent was successful.…”

Section: Discussionmentioning

confidence: 94%

“…The radial expansion force of self‐expanding polydioxanone stents, crucial to remodeling and resolution of stricture, is reportedly close to 90% of modern FCSEMS . Accordingly, the only clinical study on polydioxanone BDBS use in human biliary duct with either postoperative stricture of hepaticojejunal anastomosis or stricture related to chronic pancreatitis presented an 18% recurrence rate in 23 months of follow up …”

Section: Discussionmentioning

confidence: 97%

“…With BDBS, certain drawbacks of conventional stents may be avoided, especially those associated with repeated endoscopies for stent exchange and episodes of cholangitis and difficult removal if a stent is left in situ for an inadvertently long period of time . However, the unavailability of an insertion device for BDBS has until recently prevented their endoscopic use; polydioxanone is currently the only material so far used in the manufacture of BDBS …”

Section: Discussionmentioning

confidence: 99%

“…2,3 However, the unavailability of an insertion device for BDBS has until recently prevented their endoscopic use; polydioxanone is currently the only material so far used in the manufacture of BDBS. [5][6][7] Earlier research has been conducted on polylactide BDBS in an animal model of biliary leak and biliary stricture. 8,9 Degradation characteristics of polydioxanone currently in use have been considered more favorable for the human bile environment than its co-polymers polylactide and polycaprolactone.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic biodegradable biliary stents in the treatment of benign biliary strictures: First report of clinical use in patients

Siiki

Rinta-Kiikka

Sand

et al. 2016

Digestive Endoscopy

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The first clinical experience of endoscopically inserted polydioxanone biodegradable biliary stents (BDBS) in the treatment of benign biliary strictures is reported. Two patients with a benign common bile duct stricture were endoscopically treated with 8-mm-bore BDBS during endoscopic retrograde cholangiography. Both BDBS insertions were technically successful and without adverse events. At 6 months, the stricture resolution was excellent and BDBS degradation was predicted in repeated magnetic resonance imaging. The first experience with endoscopic BDBS seems promising in the treatment of benign biliary strictures. During 6 months of follow up, BDBS seemed sufficient for remodeling and resolution of strictures. Further studies are needed to confirm the effectiveness of biodegradable biliary stents in endoscopic management of benign biliary strictures.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Endoscopic biodegradable biliary stents in the treatment of benign biliary strictures: First report of clinical use in patients

Siiki

Rinta-Kiikka

Sand

et al. 2016

Digestive Endoscopy

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Biosynthetic Plastics as Tunable Elastic and Visible Stent with Shape‐Memory to Treat Biliary Stricture

et al. 2023

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Common biliary tract is ≈4 mm in diameter to deliver bile from liver to small intestine to help digestion. The abnormal narrowing leads to severe symptoms such as pain and nausea. Stents are an effective treatment. Compared with non‐degradable stents which require repeated removal, biodegradable stents have the advantage of reducing secondary injury related to endoscopic operation and patient burden. However, current biodegradable materials may cause tissue hyperplasia and the treatment method does not target etiology of stricture. So recurrence rates after biodegradable stent implantation are still high. Here, a biodegradable helical stent fabricated from biosynthetic P(3HB‐co‐4HB) is reported. Tunable properties can be acquired through altering culture substrates. Stent shows shape memory in various solvents. The stent has an optimized design with helical structure and outer track. The self‐expanding of helical structure and double drainage realized by outer track greatly improve drainage of bile. Importantly, stent‐loading triamcinolone acetonide can inhibit proliferation of fibroblasts and reduce incidence of restricture. Therapeutic effect is also demonstrated in minipigs with biliary stricture. The results of minipig experiments show that biliary duct in treatment group is unobstructed and tissue hyperplasia is effectively inhibited.

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A poly(L‐lactic acid) monofilament with high mechanical properties for application in biodegradable biliary stents

Tian

Zhang

Cheng

et al. 2020

J of Applied Polymer Sci

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In this article, a poly(L‐lactic acid) (PLLA) monofilament with high mechanical properties which can be used to construct biodegradable biliary stents (BBS) is prepared. Compared with a commercial polydioxanone (PDO) suture, the PLLA monofilament has much higher Young's modulus. As a result, chronic outward force (COF) of the stent braided by PLLA monofilament is more than three times higher than that of the stent braided by PDO suture. Furthermore, by physicochemical indexes characterizations, it is acceptable that the PLLA monofilament has stable Young's modulus and higher elongation at break without brittle fracture risk during degradation in bile. In contrast, although PDO suture can also maintain Young's modulus well during degradation, its elongation at break is attenuated rapidly, which shows a high brittle fracture risk. These results indicate that PLLA monofilament is more suitable for constructing BBS with high COF, which are promising in treating more complex biliary strictures that need longer support time.

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Benign biliary strictures refractory to standard bilioplasty treated using polydoxanone biodegradable biliary stents: retrospective multicentric data analysis on 107 patients

Cited by 74 publications

References 24 publications

Endoscopic biodegradable biliary stents in the treatment of benign biliary strictures: First report of clinical use in patients

Endoscopic biodegradable biliary stents in the treatment of benign biliary strictures: First report of clinical use in patients

Biosynthetic Plastics as Tunable Elastic and Visible Stent with Shape‐Memory to Treat Biliary Stricture

A poly(L‐lactic acid) monofilament with high mechanical properties for application in biodegradable biliary stents

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