Abstract
Background
Biliary stricture is a common cause of morbidity after liver transplantation. We previously developed a duct-to-duct biliary anastomosis technique using a biodegradable stent tube and confirmed the feasibility and safety of biliary stent use. However, the duration and mechanism of biliary stent absorption in the common bile duct remain unclear.
Materials and methods
Radiopaque biodegradable biliary stents were created using a copolymer of L-lactide and ε-caprolactone (70: 30) and coated with barium sulfate. Stents were surgically implanted in the common bile duct of 11 pigs. Liver function tests and computed tomography (CT) scans were performed postoperatively, and autopsies were conducted 6 months after biliary stent implantation.
Results
After the surgery, all 11 pigs had normal liver function and survived without any significant complications such as biliary leakage. A CT scan at 2 months post-procedure showed that the biliary stents were located in the hilum of the liver. The stents were not visible by CT scan at the 6-month follow-up examination.
Conclusions
The surgical implantation of radiopaque biodegradable biliary stents in biliary surgery represents a new option for duct-to-duct biliary reconstruction. This technique appears to be feasible and safe and is not associated with any significant biliary complications. The advantage of coated biliary stent use is that it may be visualized using abdominal radiography such as CT.
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Abbreviations
- LDLT:
-
Living donor liver transplantation
- CT:
-
Computed tomography
- P(LA/CT):
-
Copolymer of L-lactide and ε-caprolactone
- PBS:
-
Phosphate buffered saline
- Mw:
-
Molecular weight
- GCP:
-
Gel permeation chromatography
- 1H-NMR:
-
Proton nuclear magnetic resonance
- CBD:
-
Common bile duct
- T-Bil:
-
Total bilirubin
- ALT:
-
Alanine aminotransferase
- HPLC:
-
High-performance liquid chromatography
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Acknowledgments
The authors thank Junichi Ide, Kasumi Ogata, and Shinji Namoto (JMS Co., LTD. Hiroshima, Japan) for providing the bioabsorbable biliary stents. This work was supported in part by a Grant-in-Aid for Challenging Exploratory Research (24659609 [to H.T.]) from the Japan Society for the Promotion of Science. This work was carried out in part at the Analysis Center at the Life Science Center at Hiroshima University.
Authors’ contributions
Hirotaka Tashiro and Prof. Hideki Ohdan have contributed in the study conception and design. Yoshihiro Mikuriya, Shintato Kuroda, and Masakazu Hashimoto have contributed in the acquisition of the data. Tokunori Taniura and Tsuyoshi Kobayashi have contributed in the analysis and interpretation of the data. Hirotaka Tashiro and Yoshisato Tanimoto have contributed in drafting of the manuscript. Prof. Hideki Ohdan has contributed in the critical revision of the manuscript.
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All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.
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Tanimoto, Y., Tashiro, H., Mikuriya, Y. et al. Radiopaque biodegradable stent for duct-to-duct biliary reconstruction in pigs. Langenbecks Arch Surg 401, 513–517 (2016). https://doi.org/10.1007/s00423-016-1442-z
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DOI: https://doi.org/10.1007/s00423-016-1442-z