Tomáš Grolich1, Michal Crha2, Ladislav Novotný3, Zdeněk Kala4, Aleš Hep5, Alois Nečas2, Jan Hlavsa4, Ladislav Mitáš4, Jan Misík6. 1. Department of Surgery, Masaryk University, Brno, Czech Republic. Electronic address: tgrolich@fnbrno.cz. 2. CEITEC - Central European Institute of Technology, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic. 3. Institute of Pathology and Parasitology, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic; Finn Pathologists, Department of histology, Weybread, United Kingdom. 4. Department of Surgery, Masaryk University, Brno, Czech Republic. 5. Department of Hepatogastroenterology, Masaryk University, Brno, Czech Republic. 6. Faculty of Military Health Sciences, Department of Toxicology, University of Defence, Hradec Kralove, Czech Republic.
Abstract
BACKGROUND: Treatment or prevention of a benign biliary tree stricture is an unresolved problem. A novel self-expandable biodegradable polydioxanon biliary stent in a porcine model was studied. MATERIALS AND METHODS: This new stent was used in 23 pigs. Feasibility and safety of surgical stenting, time of biodegradation, and histologic reaction in 2, 8, 13, and 20 wk of a follow-up were studied. All stents were inserted into a common bile duct through a duodenal papilla following small dilatation. After surgical evaluation of abdominal cavities, the pigs were sacrificed to remove common bile ducts with the stents. All bile ducts were assessed by macroscopic and histopathologic examination. RESULTS: Self-expansion was correct in all cases. Neither bile duct obstruction nor postsurgical complications were observed. Macroscopic evaluation indicated lightening of the stent color in 2 wk, a partial disintegration in 8 wk, and a complete absorption in 13 and 20 wk. Histologic evaluation in general substantiated a mild-to-moderate inflammatory reaction in the lamina propria during the whole follow up and had no clinical consequences. No cholangitis, necrosis, abscess, or excessive fibroplasia was found in a hepatoduodenal ligament. CONCLUSIONS: Our results suggest that polydioxanon biodegradable self-expanding stents seem to be useful for biliary system implantation, offer a good biocompatibility, and completely degrade within 13 wk.
BACKGROUND: Treatment or prevention of a benign biliary tree stricture is an unresolved problem. A novel self-expandable biodegradable polydioxanon biliary stent in a porcine model was studied. MATERIALS AND METHODS: This new stent was used in 23 pigs. Feasibility and safety of surgical stenting, time of biodegradation, and histologic reaction in 2, 8, 13, and 20 wk of a follow-up were studied. All stents were inserted into a common bile duct through a duodenal papilla following small dilatation. After surgical evaluation of abdominal cavities, the pigs were sacrificed to remove common bile ducts with the stents. All bile ducts were assessed by macroscopic and histopathologic examination. RESULTS: Self-expansion was correct in all cases. Neither bile duct obstruction nor postsurgical complications were observed. Macroscopic evaluation indicated lightening of the stent color in 2 wk, a partial disintegration in 8 wk, and a complete absorption in 13 and 20 wk. Histologic evaluation in general substantiated a mild-to-moderate inflammatory reaction in the lamina propria during the whole follow up and had no clinical consequences. No cholangitis, necrosis, abscess, or excessive fibroplasia was found in a hepatoduodenal ligament. CONCLUSIONS: Our results suggest that polydioxanon biodegradable self-expanding stents seem to be useful for biliary system implantation, offer a good biocompatibility, and completely degrade within 13 wk.
Authors: Miguel A De Gregorio; Eva Criado; Jose A Guirola; Enrique Alvarez-Arranz; Mercedes Pérez-Lafuente; Marta Barrufet; Maria D Ferrer-Puchol; Sandra Lopez-Minguez; Jose Urbano; Carlos Lanciego; Alexander Aguinaga; Antonio Capel; Maria D Ponce-Dorrego; Abel Gregorio Journal: Eur Radiol Date: 2020-03-27 Impact factor: 5.315