Sun Qiqi, Shen Zefeng, Liang Xiao, He Yingxu, Kong Deling, Midgley Adam C, Wang Kai
Key Laboratory of Bioactive Materials for the Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071, China.
Department of General Surgery, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.
Materials (Basel). 2021 Dec 6;14(23):7468. doi: 10.3390/ma14237468.
Bile duct injury (BDI) and bile tract diseases are regarded as prominent challenges in hepatobiliary surgery due to the risk of severe complications. Hepatobiliary, pancreatic, and gastrointestinal surgery can inadvertently cause iatrogenic BDI. The commonly utilized clinical treatment of BDI is biliary-enteric anastomosis. However, removal of the Oddi sphincter, which serves as a valve control over the unidirectional flow of bile to the intestine, can result in complications such as reflux cholangitis, restenosis of the bile duct, and cholangiocarcinoma. Tissue engineering and biomaterials offer alternative approaches for BDI treatment. Reconstruction of mechanically functional and biomimetic structures to replace bile ducts aims to promote the ingrowth of bile duct cells and realize tissue regeneration of bile ducts. Current research on artificial bile ducts has remained within preclinical animal model experiments. As more research shows artificial bile duct replacements achieving effective mechanical and functional prevention of biliary peritonitis caused by bile leakage or obstructive jaundice after bile duct reconstruction, clinical translation of tissue-engineered bile ducts has become a theoretical possibility. This literature review provides a comprehensive collection of published works in relation to three tissue engineering approaches for biomimetic bile duct construction: mechanical support from scaffold materials, cell seeding methods, and the incorporation of biologically active factors to identify the advancements and current limitations of materials and methods for the development of effective artificial bile ducts that promote tissue regeneration.
由于存在严重并发症的风险,胆管损伤(BDI)和胆道疾病被视为肝胆外科手术中的突出挑战。肝胆、胰腺和胃肠道手术可能会无意中导致医源性BDI。BDI常用的临床治疗方法是胆肠吻合术。然而,作为控制胆汁单向流入肠道的瓣膜的奥迪括约肌的切除,可能会导致诸如反流性胆管炎、胆管再狭窄和胆管癌等并发症。组织工程和生物材料为BDI治疗提供了替代方法。重建具有机械功能和仿生结构以替代胆管,旨在促进胆管细胞向内生长并实现胆管组织再生。目前关于人工胆管的研究仍停留在临床前动物模型实验阶段。随着越来越多的研究表明人工胆管替代物在胆管重建后能有效预防胆汁渗漏或梗阻性黄疸引起的胆汁性腹膜炎,组织工程胆管的临床转化已成为一种理论上的可能性。这篇文献综述全面收集了已发表的有关仿生胆管构建的三种组织工程方法的研究成果:支架材料的机械支撑、细胞接种方法以及生物活性因子的掺入,以确定用于开发促进组织再生的有效人工胆管的材料和方法的进展及当前局限性。