Weickert U, Weddeling S, Subkowski T, Eickhoff A, Reiss G
Department of Medicine II, SLK-Kliniken Heilbronn, Germany.
Institute of Anatomy and Clinical Morphology, University of Witten/Herdecke, Witten, Germany.
Z Gastroenterol. 2016 Jul;54(7):629-33. doi: 10.1055/s-0042-101771. Epub 2016 Jul 18.
Endoscopic stenting of the bile duct is a standard procedure for almost 35 years. In the case of long-term stenting occlusion of the stent is a major concern. Therefore optimizing biliary stents with respect to their patency is of great importance. We tested in an in animal study if coating of self-expanding metal stents with hydrophobin alone or hydrophobin with heparin reduces stent clogging as there were promising results in an in vitro study with this approach.
In a randomized prospective animal study we implanted self-expanding metal stents either native or coated with hydrophobin alone or coated with hydrophobin and heparin into the bile duct of 15 pigs. After a survival period of 6 weeks we measured which part of the stent surface (%) was covered with clogging material using a commercially available image editing program on scanning electron microscopic images.
We found no differences between the native self-expanding metals stents and those coated with hydrophobin alone or hydrophobin and heparin.
There are important differences in the clogging process between in vitro and in vivo models. Coating with hydrophobin with or without heparin is not able to inhibit the clogging process in an animal model.
胆管内镜支架置入术已成为一项标准操作近35年。在长期支架置入的情况下，支架堵塞是一个主要问题。因此，优化胆管支架的通畅性至关重要。在一项动物研究中，我们测试了单独用疏水蛋白或疏水蛋白与肝素涂层的自膨式金属支架是否能减少支架堵塞，因为在体外研究中采用这种方法取得了有前景的结果。
在一项随机前瞻性动物研究中，我们将未处理的、单独用疏水蛋白涂层或用疏水蛋白与肝素涂层的自膨式金属支架植入15头猪的胆管。在6周的存活期后，我们使用商用图像编辑程序在扫描电子显微镜图像上测量支架表面被堵塞物质覆盖的部分（%）。
我们发现未处理的自膨式金属支架与单独用疏水蛋白涂层或疏水蛋白与肝素涂层的支架之间没有差异。
体外和体内模型在堵塞过程中存在重要差异。在动物模型中，无论有无肝素，用疏水蛋白涂层都无法抑制堵塞过程。
