Grolich Tomáš, Crha Michal, Novotný Ladislav, Kala Zdeněk, Hep Aleš, Nečas Alois, Hlavsa Jan, Mitáš Ladislav, Misík Jan
Department of Surgery, Masaryk University, Brno, Czech Republic.
CEITEC - Central European Institute of Technology, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic.
J Surg Res. 2015 Feb;193(2):606-12. doi: 10.1016/j.jss.2014.08.006. Epub 2014 Aug 9.
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.
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.
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.
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.
良性胆管狭窄的治疗或预防仍是一个未解决的问题。在猪模型中对一种新型的可自膨胀生物可降解聚二氧六环酮胆管支架进行了研究。
将这种新型支架应用于23头猪。研究了手术置入支架的可行性和安全性、支架的生物降解时间以及随访2周、8周、13周和20周时的组织学反应。所有支架在轻微扩张后通过十二指肠乳头插入胆总管。在对腹腔进行手术评估后，处死猪以取出带有支架的胆总管。所有胆管均通过宏观和组织病理学检查进行评估。
所有病例中支架的自膨胀均正常。未观察到胆管梗阻或术后并发症。宏观评估显示，支架颜色在2周时变浅，8周时部分崩解，13周和20周时完全吸收。组织学评估总体上证实，在整个随访期间固有层存在轻度至中度炎症反应，但无临床后果。在肝十二指肠韧带中未发现胆管炎、坏死、脓肿或过度纤维化。
我们的结果表明，聚二氧六环酮生物可降解自膨胀支架似乎可用于胆道系统植入，具有良好的生物相容性，并在13周内完全降解。
