Weixing Zhang1, Fariha Kanwal2, Muhammad Fayyaz Ur Rehman3, Xinjian Wan4. 1. Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China. 2. Shanghai Jiaotong University, Shanghai, China. 3. University of Sargodha, Sargodha, Pakistan. 4. Digestive Endoscopic Center, Shanghai Jiao Tong University, Affiliated Sixth People's Hospital, Shanghai, China.
Abstract
BACKGROUND: Benign biliary strictures (BBS) are widely treated by endoscopic procedures involving temporary stent placement. Occasionally, stents are required to be removed, making the treatment process very painful as well as expensive. Until now, no effective biodegradable biliary stents are available for clinical applications. This study aims to investigate the safety and efficacy of biodegradable polydioxanone (PDO) and polylactic acid (PLA) braided biodegradable biliary stents (BDBS) both in vitro and in vivo. METHODS: Three different diameter monofilaments of PDO (0.30, 0.35, and 0.40 mm) and PLA (0.10, 0.15, and 0.20 mm) were braided to biliary stents and their mechanical properties were studied. The stents were placed in an ex vivo bile duct model perfused with porcine bile, taken out, and observed every week until these were completely degraded. After the bile duct stenosis model was established successfully in piglet, stents with appropriate mechanical properties were further examined under endoscopy; haematology, patency time of stents, and pathological changes were observed for eight months. RESULTS: A total of 10 pigs were included (two groups; 5 PDO, 5 PLA) in the study. The patency time of the PLA group was significantly longer than that of the PDO stent group (25.7 ± 5.6w vs 11.3 ± 3.4w, respectively) in pigs. CONCLUSION: Our results prospect biodegradable PLA and PDO braided biliary stents could be a better choice to treat benign biliary strictures while degrading at different rates.
BACKGROUND: Benign biliary strictures (BBS) are widely treated by endoscopic procedures involving temporary stent placement. Occasionally, stents are required to be removed, making the treatment process very painful as well as expensive. Until now, no effective biodegradable biliary stents are available for clinical applications. This study aims to investigate the safety and efficacy of biodegradable polydioxanone (PDO) and polylactic acid (PLA) braided biodegradable biliary stents (BDBS) both in vitro and in vivo. METHODS: Three different diameter monofilaments of PDO (0.30, 0.35, and 0.40 mm) and PLA (0.10, 0.15, and 0.20 mm) were braided to biliary stents and their mechanical properties were studied. The stents were placed in an ex vivo bile duct model perfused with porcine bile, taken out, and observed every week until these were completely degraded. After the bile duct stenosis model was established successfully in piglet, stents with appropriate mechanical properties were further examined under endoscopy; haematology, patency time of stents, and pathological changes were observed for eight months. RESULTS: A total of 10 pigs were included (two groups; 5 PDO, 5 PLA) in the study. The patency time of the PLA group was significantly longer than that of the PDO stent group (25.7 ± 5.6w vs 11.3 ± 3.4w, respectively) in pigs. CONCLUSION: Our results prospect biodegradable PLA and PDO braided biliary stents could be a better choice to treat benign biliary strictures while degrading at different rates.
Authors: Aatur D Singhi; Marina N Nikiforova; Jennifer Chennat; Georgios I Papachristou; Asif Khalid; Mordechai Rabinovitz; Rohit Das; Savreet Sarkaria; M Samir Ayasso; Abigail I Wald; Sara E Monaco; Michael Nalesnik; N Paul Ohori; David Geller; Allan Tsung; Amer H Zureikat; Herbert Zeh; J Wallis Marsh; Melissa Hogg; Kenneth Lee; David L Bartlett; James F Pingpank; Abhinav Humar; Nathan Bahary; Anil K Dasyam; Randall Brand; Kenneth E Fasanella; Kevin McGrath; Adam Slivka Journal: Gut Date: 2019-04-10 Impact factor: 23.059