Bacterial biofilm and clogging of biliary stents.
Endoscopic biliary stenting has become a standard palliative treatment for obstructive jaundice due to malignancies of the pancreas and the hepatobiliary system. Despite the high initial success rate in achieving biliary drainage, durable endoscopic stenting has been limited by the clogging of biliary stents, usually after 4-5 months, due to formation of an adherent bacterial biofilm. Various methods have been investigated for the prevention of bacterial adhesion and prolongation of stent patency. These include: 1) prophylactic use of antimicrobial agents and bile salts; 2) testing of new stent material and new designs for these biliary stents; and 3) the recent introduction of self-expandable metal stents. Each method has its own merits as well as specific problems. This article reviews the pathogenesis of biofilm formation on the biliary stents and the latest status of research in avoiding the problem of stent occlusion.
Department of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong.
J J
JJ
Sung
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000209:etiology*; D001647:Bile Acids and Salts / Q000627:therapeutic use; D001660:Biliary Tract Diseases / Q000188:drug therapy / Q000209:etiology*; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects*; D001672:Biocompatible Materials; D018441:Biofilms; D017753:Ecosystem; D004867:Equipment Design; D006801:Humans; D015607:Stents / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D001647:Bile Acids and Salts; D001672:Biocompatible Materials