An extrahepatic bile duct grafting using a bioabsorbable polymer tube.
BACKGROUND
Thus far, no ideal substitutions have been developed for completely replacing the extrahepatic bile duct (EHBD).


METHODS
We used a bioabsorbable polymer tube (BAPT) for the complete reconstruction of an EHBD in pigs. A 2-cm-long EHBD was resected from the duodenal side, and a 4-cm-long BAPT graft was implanted at that site. The animals were re-laparotomized at 1 or 4 months after the grafting; subsequently, gross, histological, and blood chemical studies were performed.


RESULTS
At 1 month after grafting, tubular structure was observed in all resected specimens, and the lumen of the graft site had remnants of degraded BAPT. Gross examination at 4 months after grafting revealed that the BAPT had been completely absorbed, and the graft site was indistinguishable from the native extrahepatic bile duct. The lengths of the graft region at 4 months were 70% of the replaced BAPT. Simultaneously performed histological examination revealed the growth of a neo-bile duct at the graft site, with an epithelium identical to that of the native bile duct.


CONCLUSIONS
The BAPT graft implanted in this study completely replaced the EHBD defect. Hence, BAPT has the potential for application as a novel treatment modality for hepatobiliary diseases.
Gastrointestinal Center, Department of Surgery, Saitama Medical University, International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan. aikawama@ybb.ne.jp
Masayasu
M
Aikawa
Mitsuo
M
Miyazawa
Kojun
K
Okamoto
Yasuko
Y
Toshimitsu
Katsuya
K
Okada
Naoe
N
Akimoto
Yosuke
Y
Ueno
Isamu
I
Koyama
Yoshito
Y
Ikada
D020341:Absorbable Implants; D000818:Animals; D017734:Bile Ducts, Extrahepatic / Q000601:surgery*; D002768:Choledochostomy / Q000379:methods*; D001651:Cholestasis, Extrahepatic / Q000601:surgery*; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D007813:Laparotomy; D011108:Polymers; D011474:Prosthesis Design; D015607:Stents; D013552:Swine
D011108:Polymers