title: A new biodegradable stent for the pancreaticojejunal anastomosis after pancreaticoduodenal resection: in vitro examination and pilot experiences in humans.
abstract: We sought to develop a biodegradable pancreatic stent that could be easily placed at operation into the human pancreatic duct and the degradation of which could be easily followed up. Spiral-shaped, gamma-sterilized stents were manufactured of 0.4-mm polylactide wire in which there was added 23 weight-% barium sulfate. The biodegradability of the stents was studied in vitro at two different pH values, the first resembling that of pancreatic juice and the other that of bile. The effects of enzymoactivity in the test solution and the composition of the stents (with or without barium addition) also were tested. These kinds of stents have been experimented with in two pilot patients. Degradation of the stents occurred from 24 to 52 weeks of incubation. Alkaline milieu together with the presence of pancreatic enzyme made the stents degrade twice as fast as when either alkaline milieu or enzyme was present. In the milieu resembling pancreatic juice, barium sulfate had no effect on the degradation time. Neither of the pilot patients had any postoperative complications. Biodegradable, x-ray-positive stents degrade faster in pancreatic than in biliary milieu. Their safety and efficacy in human pancreaticojejunal anastomoses need further study.
authors.affiliation: Department of Surgery, Tampere University Hospital and Medical School, University of Tampere, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Parviainen
authors.forename: J
authors.initials: J
authors.lastname: Sand
authors.forename: A
authors.initials: A
authors.lastname: Harmoinen
authors.forename: H
authors.initials: H
authors.lastname: Kainulainen
authors.forename: T
authors.initials: T
authors.lastname: Välimaa
authors.forename: P
authors.initials: P
authors.lastname: Törmälä
authors.forename: I
authors.initials: I
authors.lastname: Nordback
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000295:instrumentation*; D001672:Biocompatible Materials; D001673:Biodegradation, Environmental; D005260:Female; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008197:Lymph Node Excision; D008279:Magnetic Resonance Imaging; D008297:Male; D010183:Pancreatic Ducts / Q000601:surgery*; D010189:Pancreatic Juice; D010190:Pancreatic Neoplasms / Q000601:surgery*; D010865:Pilot Projects; D011091:Polyesters / Q000493:pharmacokinetics; D011474:Prosthesis Design; D015607:Stents
chemical_list: D001672:Biocompatible Materials; D011091:Polyesters; C033616:poly(lactide)