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A novel biodegradable biliary stent in the normal duct hepaticojejunal anastomosis: an 18-month follow-up in a large animal model.
Laukkarinen, Johanna M; Sand, Juhani A; Chow, Pierce; Juuti, Hanne; Kellomäki, Minna; Kärkkäinen, Päivi; Isola, Jorma; Yu, Sidney; Somanesan, Satchithanantham; Kee, Irene; Song, In Chin; Ng, Teck Hin; Nordback, Isto H.
Afiliação
  • Laukkarinen JM; Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Teiskontie 35, Tampere 33521, Finland.
J Gastrointest Surg ; 11(6): 750-7, 2007 Jun.
Article em En | MEDLINE | ID: mdl-17436052
Creating a well-functioning hepaticojejunostomy (HJ) anastomosis with nondilated bile ducts remains a challenge. Our aim was to study the use in a large animal model of a novel, braided polylactide barium sulfate biodegradable biliary stent (BDBS) without external connection and with no need for later removal. Fifty swine were randomly operated on for Roux-Y HJ with or without BDBS in the anastomosis, and followed up (dynamic biligraphy, x-ray, serum determinations, anastomosis inner diameter, and histology) for 1.5, 3, 6, 12, and 18 months. During the follow-up, one nonstented animal died because of anastomotic leakage. In x-ray BDBS was seen in place until 1.5 months in all of the stented animals. In the nonstented animals HJ anastomosis inner diameter was decreased at 18 months [6.3 (5.0-7.0) mm vs 7.4 (7.0-9.0) mm, p = 0.05] and liver clearance reduced at 12 and 18 months compared to stented animals. Serum liver values and liver and bile duct histology did not differ between the groups. We conclude that this novel BDBS is easy to insert into the HJ anastomosis with nondilated ducts. It is nontoxic, dissolves safely, and may be associated with a larger and better draining anastomosis at 18-month follow-up. These results encourage us to proceed to clinical studies.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Portoenterostomia Hepática / Stents / Implantes Absorvíveis Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Animals Idioma: En Ano de publicação: 2007 Tipo de documento: Article
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Portoenterostomia Hepática / Stents / Implantes Absorvíveis Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Animals Idioma: En Ano de publicação: 2007 Tipo de documento: Article