Radiopaque biodegradable stent for duct-to-duct biliary reconstruction in pigs

Tanimoto, Yoshisato; Tashiro, Hirotaka; Mikuriya, Yoshihiro; Kuroda, Satoshi; Hashimoto, Masakazu; Kobayashi, Tsuyoshi; Taniura, Tokunori; Ohdan, Hideki

doi:10.1007/s00423-016-1442-z

Cited by 10 publications

(11 citation statements)

References 10 publications

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“…Initial animal studies were carried out in the form of a tube to make the thickness of the BS as thin as possible, and it was con rmed that it was completely degraded within six months. [16][17][18] Then, a clinical trial using this tube-type BS in DDLT patients was conducted, and its potential was suggested. 25 However, additional clinical trials using this tube-type BS are not in progress, and the effect and bene t cannot be objectively presented.…”

Section: Discussionmentioning

confidence: 99%

“…In previous reports, the use of biodegradable stents (BS) in animal models for biliary reconstruction led to good mechanical support properties and biocompatibility. [16][17][18][19][20] Also, BS could serve as carriers for the controlled release of drugs, therefore playing the role of local drug treatment for the prevention of brosis at the anastomotic site. 21 However, there is a chance of stent or tube fracture, which can occur at any point during the biodegradation process.…”

Section: Introductionmentioning

confidence: 99%

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Preventive Effect of Biodegradable Stents On Biliary Stricture And Fibrosis After Biliary Anastomosis In A Porcine Model

Kwon

Choi

Kim

et al. 2021

Preprint

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The aim of this animal study was to evaluate the preventive effect of novel biodegradable stents (BS) on biliary stricture and fibrosis after duct-to-duct (DD) biliary anastomosis. Ten mini-pigs were allocated to the control group (n = 5) and or the stent group (n = 5). The common bile duct was exposed through surgical laparotomy, and then resected transversely. In the stent group, a 4 mm or 6 mm polydioxanone/magnesium sheath core BS was inserted according to the width of the bile duct, followed by DD biliary anastomosis. In the control group, DD biliary anastomosis was performed without BS insertion. In the stent group, stents were observed without deformity for up to four weeks in all animals. Eight weeks later, histopathologic examination revealed that the common bile duct of the anastomosis site was relatively narrower in circumference in the control group compared to the stent group. The degree of fibrosis in the control group was more marked than in the stent group (3.84 mm vs. 0.68 mm, respectively, p < 0.05). Our study showed that novel BS maintained their original shape and radial force for an adequate time and then disappeared without adverse events.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Preventive Effect of Biodegradable Stents On Biliary Stricture And Fibrosis After Biliary Anastomosis In A Porcine Model

Kwon

Choi

Kim

et al. 2021

Preprint

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“…Shi et al (2013) presented a study on the preventative stenting of biliary anastomosis with a completely different type of short stent covered with chemotherapeutics placed through the anastomosis without the need of tensile strength. Tanimoto et al (2016) inserted a stent (made by copolymerization of L-lactide and ε-caprolactone and coated with barium sulphate) into the transected common bile duct and secured it with 6-0 polydioxanone absorbable monofilament suture. This was the only experimental study we found dealing with the preventive trans-anastomotic stenting with a radiologic (computed tomography) follow-up.…”

Section: Discussionmentioning

confidence: 99%

Duodenum sparing technique for preventive stenting of biliary tract anastomosis in pigs

et al. 2019

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The main aim of this study was to find a standardized method for preventive stenting of biliary tract anastomosis with biodegradable self-expandable stent from polydioxanone and to evaluate the functionality of the stent. The experimental study was conducted using four pigs with a follow-up of eight weeks. The procedure was done under general anaesthesia. The function of the stent was verified by clinical stage, blood test, magnetic resonance cholangiopancreatography and necropsy. Our duodenum sparing technique was described in detail and photographically documented. All pigs finished the follow-up period without clinical, laboratory or radiologic signs of biliary obstruction. Necropsy did not reveal complication of the procedure or anastomotic stricture. In conclusion, this study demonstrated a simple new duodenum sparing method of transanastomotic insertion of a biodegradable self-expandable stent from polydioxanone. We did not find any complications during the follow-up. This method will be used in our follow-up study with an extended experimental control group of animals and a longer follow-up period to verify the preventive functionality of this stent.

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“…16 It has been proved that bile as a degradation medium is more aggressive than PBS and can accelerate the degradation. 17 Therefore, it can be inferred that the degradation of PLLA braided stents in PBS is slower than that in bile and can not truly reflect that in the bile duct. It is necessary to investigate the mechanical properties of PLLA braided stents during degradation in the bile duct environment to more truly evaluate their application prospects in treating severe benign biliary strictures.…”

Section: Introductionmentioning

confidence: 99%

“…In fact, the degradation behaviors of PLLA are significantly influenced by the environmental conditions 16 . It has been proved that bile as a degradation medium is more aggressive than PBS and can accelerate the degradation 17 . Therefore, it can be inferred that the degradation of PLLA braided stents in PBS is slower than that in bile and can not truly reflect that in the bile duct.…”

Section: Introductionmentioning

confidence: 99%

A poly(l‐lactic acid) braided stent with high mechanical properties during in vitro degradation in bile

Zhao

Tian

Hua

et al. 2021

J of Applied Polymer Sci

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In this article, the mechanical properties and physicochemical indexes of a poly(L-lactic acid) (PLLA) braided stent during in vitro degradation in bile for 270 days are characterized to investigate its applications in treating biliary strictures. The PLLA braided stent always maintains structural integrity well macroscopically without cracks or pits microscopically. During degradation, radial compressive force and chronic outward force are increased by 25.1% and 14.3%, respectively, bending stiffness and axial force are increased by 3.0% and 4.9%, respectively. These results indicate that PLLA braided stent can keep sufficient radial force and good bending performance during degradation in bile for 270 days, showing promising application prospects in treating severe benign biliary strictures demanding support for over half a year. Furthermore, almost no mass loss and 42.4% attenuation in molecular weight indicate the degradation mechanism of bulk erosion without obvious autocatalysis, causing decrease in bile pH. Degradation rate constant is 0.002 day À1 and crystallinity is increased by 8%. These results explain that PLLA braided stent can keep high mechanical properties during degradation in bile for 270 days, which is in the early stage of degradation. This study may bring new ideas into the applications of PLLA braided stents in treating biliary strictures.

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Radiopaque biodegradable stent for duct-to-duct biliary reconstruction in pigs

Cited by 10 publications

References 10 publications

Preventive Effect of Biodegradable Stents On Biliary Stricture And Fibrosis After Biliary Anastomosis In A Porcine Model

Preventive Effect of Biodegradable Stents On Biliary Stricture And Fibrosis After Biliary Anastomosis In A Porcine Model

Duodenum sparing technique for preventive stenting of biliary tract anastomosis in pigs

A poly(l‐lactic acid) braided stent with high mechanical properties during in vitro degradation in bile

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