Endoluminal reconstruction of the canine common biliary duct

Zografakis, John G.; B, Jones; Ravichardran, Pars; Evancho-Chapman, Michelle; Schmidt, Steven; Arends, Dane; Funk, Karla M; Gingras, Peter

doi:10.1016/s0149-7944(02)00726-2

Cited by 18 publications

(9 citation statements)

References 8 publications

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“…Extrahepatic bile duct injuries, such as transections, stenoses and biliary leaks, are well‐known complications of upper abdominal surgery. The popularization of laparoscopic cholecystectomy may explain the increase in the numbers of these reported injuries (Zografakis et al ., ). Although the routine treatment, such as stent placement, PTBD and bilioenteric anastomosis, is very effective at relieving CBD obstructions and repair of injured bile duct, there is a high risk of complications, for example, occlusion, infections, formation of scar tissue and stenosis, and reoperation risks are very common and troublesome (Hartung et al ., ; Wills et al ., , Han et al ., , Mauri et al ., ).…”

Section: Discussionmentioning

confidence: 97%

“…Hepatobiliary surgeons often encounter various complications following surgery, such as biliary tract injury, biliary stenoses and biliary leaks. With the advent of laparoscopic biliary procedures, there has been an increase in the number of reports of benign biliary injury (Zografakis et al ., ). Clinical treatments, such as stent placement, percutaneous transhepatic biliary drainage (PTBD) and bilioenteric anastomosis, have been used to relieve common bile duct (CBD) obstructions and to repair injured bile ducts.…”

Section: Introductionmentioning

confidence: 97%

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A novel therapy strategy for bile duct repair using tissue engineering technique: PCL/PLGA bilayered scaffold with hMSCs

Zong

Wang

Yang

et al. 2015

J Tissue Eng Regen Med

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The current clinical treatments for complications caused by hepatobiliary surgery still have some inevitable weakness. The aim of the study was to fabricate a tissue-engineered bile duct that utilized a novel bilayered polymer scaffold combined with human bone marrow-derived mesenchymal stem cells (hMSCs) for new treatment of biliary disease. The biocompatibility of polycaprolactone (PCL) (PCL)/poly(lactide-co-glycolide) (PLGA) scaffold with hMSCs was first examined, and the hMSC-PCL/PLGA constructs (MPPCs) prepared. The MPPCs and blank scaffolds were then transplanted into 18 pigs for evaluation its efficacy on bile duct repairing, respectively. In vitro, the PCL/PLGA scaffold was verified to support the adhesion, proliferation and matrix deposition of hMSCs. There was no sign of bile duct narrowing and cholestasis in all experimental animals. At 6 months, the MPPCs had a superior repairing effect on the bile duct injury, compared with the blank PCL/PLGA scaffolds. Therefore, the implanted scaffolds could not only support the biliary tract and allow free bile flow but also had direct or indirect positive effects on repair of injured bile duct. Copyright © 2015 John Wiley & Sons, Ltd.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 97%

A novel therapy strategy for bile duct repair using tissue engineering technique: PCL/PLGA bilayered scaffold with hMSCs

Zong

Wang

Yang

et al. 2015

J Tissue Eng Regen Med

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“…The cause of polyurethane-covered stent occlusion was previously reported to be due to a degraded polyurethane membrane and subsequent tumor ingrowth into the stent (10). In animal studies, PTFE has been shown to be quite useful for reconstructing the common bile duct (21). Schoder et al reported that using an ePTFE-FEP covered stent produced good clinical results with no stent obstruction; this type of stent has anchoring fins at its ends (19).…”

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confidence: 99%

Treatment of Malignant Biliary Obstruction with a PTFE-Covered Self-Expandable Nitinol Stent

et al. 2007

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Objective: We wanted to determine the technical and clinical efficacy of using a PTFE-covered self-expandable nitinol stent for the palliative treatment of malignant biliary obstruction. Materials and Methods:Thirty-seven patients with common bile duct strictures caused by malignant disease were treated by placing a total of 37 nitinol PTFE stents. These stents were covered with PTFE with the exception of the last 5 mm at each end; the stent had an unconstrained diameter of 10 mm and a total length of 50 80 mm. The patient survival rate and stent patency rate were calculated by performing Kaplan-Meier survival analysis. The bilirubin, serum amylase and lipase levels before and after stent placement were measured and then compared using a Wilcoxon signed-rank test. The average follow-up duration was 27.9 weeks (range: 2 81 weeks).Results: Placement was successful in all cases. Seventy-six percent of the patients (28/37) experienced adequate palliative drainage for the remainder of their lives. There were no immediate complications. Three patients demonstrated stent sludge occlusion that required PTBD (percutaneous transhepatic biliary drainage) irrigation. Two patients experienced delayed stent migration with stone formation at 7 and 27 weeks of follow-up, respectively. Stent insertion resulted in acute elevations of the amylase and lipase levels one day after stent insertion in 11 patients in spite of performing endoscopic sphincterotomy (4/6). The bilirubin levels were significantly reduced one week after stent insertion (p < 0.01). The 30-day mortality rate was 8% (3/37), and the survival rates were 49% and 27% at 20 and 50 weeks, respectively. The primary stent patency rates were 85%, and 78% at 20 and 50 weeks, respectively. Conclusion:The PTFE-covered self-expandable nitinol stent is safe to use with acceptable complication rates. This study is similar to the previous studies with regard to comparing the patency rates and survival rates.he treatment for malignant biliary obstruction includes performing surgery and interventional procedures such as insertion of a self-expanding metal stent under fluoroscopic and/or endoscopic guidance (1 6). Self-expanding metal stents have become a well-accepted palliative procedure for relieving inoperable malignant biliary obstruction. The most common causes of occlusion of an uncovered stent are sludge formation, proximal and distal tumor overgrowth, tumor ingrowth and stone formation (1,7,8). The obstruction rates for uncovered stents in a previous study varied from 5% to 100% (mean: 22%) during a 0.7 to 19 month period following stent placement (9).To improve the patency rates of metallic stents, many studies have been performed

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“…As a consequence of the increase in the number of cholecystectomies and the learning curve of surgeons, the incidence of bile duct injuries has also increased, ranging from 0.1 to 0.3% in laparoscopic procedures even at referral centers [1–5]. Among iatrogenic injuries, bile duct injury has a greater clinical significance because of its potential to produce disability and long-term sequelae [6].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic reconstruction of the extrahepatic bile duct using a jejunal tube: an innovative, more physiological and anatomical technique for biliodigestive derivation

Crema

Trentini

Teles

et al. 2014

Journal of Surgical Case Reports

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The incidence of bile duct injuries has increased as a consequence of the increasing number of cholecystectomies. However, the results of biliodigestive derivation currently used for bile duct reconstruction are unsatisfactory. We report here the case of a patient with iatrogenic Bismuth II bile duct injury and propose a new technique that permits more anatomical and physiological reconstruction of extensive bile duct injuries using transverse retubularization of a pedicled jejunal segment interposed between the bile duct and duodenum.

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Endoluminal reconstruction of the canine common biliary duct

Cited by 18 publications

References 8 publications

A novel therapy strategy for bile duct repair using tissue engineering technique: PCL/PLGA bilayered scaffold with hMSCs

A novel therapy strategy for bile duct repair using tissue engineering technique: PCL/PLGA bilayered scaffold with hMSCs

Treatment of Malignant Biliary Obstruction with a PTFE-Covered Self-Expandable Nitinol Stent

Laparoscopic reconstruction of the extrahepatic bile duct using a jejunal tube: an innovative, more physiological and anatomical technique for biliodigestive derivation

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