Self-expandable biodegradable biliary stents in porcine model

Grolich, Tomáš; Crha, Michal; Novotný, Ladislav; Kala, Zdeněk; Hep, Aleš; Nečas, Alois; Hlavsa, Jan; Mitáš, Ladislav; Mišík, Ján

doi:10.1016/j.jss.2014.08.006

Cited by 38 publications

(34 citation statements)

References 39 publications

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“…It appeared that T-tube drainage was superior to the silicone stent during the bile duct reconstruction in this experiment. Recently, biodegradable biliary stents have been developed and some experiments have reported encouraging results with them[30-32]. Future work is needed to compare the efficacy of T-tube drainage vs a biodegradable biliary stent for common bile duct reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Repair of a common bile duct defect with a decellularized ureteral graft

Cheng¹,

Xiong²,

Zhou³

et al. 2016

WJG

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AIMTo evaluate the feasibility of repairing a common bile duct defect with a decellularized ureteral graft in a porcine model.METHODSEighteen pigs were randomly divided into three groups. An approximately 1 cm segment of the common bile duct was excised from all the pigs. The defect was repaired using a 2 cm long decellularized ureteral graft over a T-tube (T-tube group, n = 6) or a silicone stent (stent group, n = 6). Six pigs underwent bile duct reconstruction with a graft alone (stentless group). The surviving animals were euthanized at 3 mo. Specimens of the common bile ducts were obtained for histological analysis.RESULTSThe animals in the T-tube and stent groups survived until sacrifice. The blood test results were normal in both groups. The histology results showed a biliary epithelial layer covering the neo-bile duct. In contrast, all the animals in the stentless group died due to biliary peritonitis and cholangitis within two months post-surgery. Neither biliary epithelial cells nor accessory glands were observed at the graft sites in the stentless group.CONCLUSIONRepair of a common bile duct defect with a decellularized ureteral graft appears to be feasible. A T-tube or intraluminal stent was necessary to reduce postoperative complications.

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Section: Discussionmentioning

confidence: 99%

Repair of a common bile duct defect with a decellularized ureteral graft

Cheng¹,

Xiong²,

Zhou³

et al. 2016

WJG

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“…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%

“…Degradation characteristics of polydioxanone currently in use have been considered more favorable for the human bile environment than its co‐polymers polylactide and polycaprolactone. The latest animal study concentrating on the use of polydioxanone BDBS has proved the degradation pattern to be fairly predictable at 3–6 months and inflammatory foreign body reaction to be temporary only . Epithelial hyperplasia, occasionally associated with the use of polydioxanone stents in the esophagus, reportedly does not occur in the bile duct .…”

Section: Discussionmentioning

confidence: 99%

“… The latest animal study concentrating on the use of polydioxanone BDBS has proved the degradation pattern to be fairly predictable at 3–6 months and inflammatory foreign body reaction to be temporary only . Epithelial hyperplasia, occasionally associated with the use of polydioxanone stents in the esophagus, reportedly does not occur in the bile duct . Additionally, the only study so far to compare tissue response of FCSEMS to BDBS found that the reaction they cause in the bile duct is different and potentially more beneficial in BDBS .…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the only study so far to compare tissue response of FCSEMS to BDBS found that the reaction they cause in the bile duct is different and potentially more beneficial in BDBS . 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: 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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