title: A novel biodegradable biliary stent in the normal duct hepaticojejunal anastomosis: an 18-month follow-up in a large animal model.
abstract: Creating a well-functioning hepaticojejunostomy (HJ) anastomosis with nondilated bile ducts remains a challenge. Our aim was to study the use in a large animal model of a novel, braided polylactide barium sulfate biodegradable biliary stent (BDBS) without external connection and with no need for later removal. Fifty swine were randomly operated on for Roux-Y HJ with or without BDBS in the anastomosis, and followed up (dynamic biligraphy, x-ray, serum determinations, anastomosis inner diameter, and histology) for 1.5, 3, 6, 12, and 18 months. During the follow-up, one nonstented animal died because of anastomotic leakage. In x-ray BDBS was seen in place until 1.5 months in all of the stented animals. In the nonstented animals HJ anastomosis inner diameter was decreased at 18 months [6.3 (5.0-7.0) mm vs 7.4 (7.0-9.0) mm, p = 0.05] and liver clearance reduced at 12 and 18 months compared to stented animals. Serum liver values and liver and bile duct histology did not differ between the groups. We conclude that this novel BDBS is easy to insert into the HJ anastomosis with nondilated ducts. It is nontoxic, dissolves safely, and may be associated with a larger and better draining anastomosis at 18-month follow-up. These results encourage us to proceed to clinical studies.
authors: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Teiskontie 35, Tampere 33521, Finland.
authors: Johanna M
authors: JM
authors: Laukkarinen
authors: Juhani A
authors: JA
authors: Sand
authors: Pierce
authors: P
authors: Chow
authors: Hanne
authors: H
authors: Juuti
authors: Minna
authors: M
authors: Kellomäki
authors: Päivi
authors: P
authors: Kärkkäinen
authors: Jorma
authors: J
authors: Isola
authors: Sidney
authors: S
authors: Yu
authors: Satchithanantham
authors: S
authors: Somanesan
authors: Irene
authors: I
authors: Kee
authors: In Chin
authors: IC
authors: Song
authors: Teck Hin
authors: TH
authors: Ng
authors: Isto H
authors: IH
authors: Nordback
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D001466:Barium Sulfate; D005500:Follow-Up Studies; D023421:Models, Animal; D011091:Polyesters; D011171:Portoenterostomy, Hepatic / Q000295:instrumentation*; D015607:Stents; D013552:Swine
chemical_list: D011091:Polyesters; D001466:Barium Sulfate; C033616:poly(lactide)