Long-term patency of Wallstent endoprostheses in benign biliary obstructions: experimental results.
OBJECTIVE
Coated and noncoated Wallstents were implanted in dogs with experimental benign common bile duct stenoses to monitor the long-term patency of self-expanding stents in the biliary system.


METHODS
Experimental common bile duct stenoses were induced with a thermal laser in 12 dogs. Three silicone-coated and 14 noncoated stents were implanted. The animals were followed up from 3 to 25 months by means of cholangiography, cholangioscopy, measurements of liver enzyme levels, autopsy, and histology.


RESULTS
Silicone coated stents failed in all cases, resulting in two total occlusions and one stent dislodgment to the bowel. Noncoated stents led to marked mucosal hyperplasia and stent narrowing in most cases, but with follow-up of more than 12 months, hyperplasia underwent regression and--except in one case--neither an increase in liver enzyme levels nor stent occlusion occurred. Histologically, the extent of hyperplasia was related to the stent position within the duct wall. With stents in the mucosal layer, hyperplasia was excessive. Once the stent entered the submucosal layer, hyperplasia was decreased.


CONCLUSIONS
In an experimental setting, mucosal hyperplasia did not compromise patency of noncoated stents in benign bile duct stenosis and regressed with late follow-up after 12 months.
Vorwerk
D
D
Department of Radiology, Technical University of Aachen, Germany.
Kissinger
G
G
Handt
S
S
Günther
R W
RW
D000818:Animals; D001652:Bile Ducts / Q000473:pathology; D002758:Cholangiography; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003137:Common Bile Duct Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D004285:Dogs; D016145:Endoscopy, Digestive System; D006965:Hyperplasia; D009092:Mucous Membrane / Q000473:pathology; D012828:Silicones; D015607:Stents; D013997:Time Factors
D012828:Silicones