title: Absorbable bioprosthesis for the treatment of bile duct injury in an experimental model.
abstract: BACKGROUND
  Cholecystectomy is a common surgical procedure in which complications may occur, such as injury to the biliary tract, which are associated with high morbidity. The aim of this study was to demonstrate the efficacy of a polymer-based absorbable bioprosthesis with bone scaffold for the treatment of bile duct injury in an animal model.
  
  
  METHODS
  An absorbable bioprosthesis was used to replace the common bile duct in 15 pigs which were divided into 3 groups with different follow-ups at 1, 3 and 6 months. The animals were anesthetized at these time points and laboratory tests, Magnetic Resonance Cholangiopancreatogram [MRCP], Choledochoscopy using Spyglass and Endoscopic retrograde Cholangiopancreatogram [ERCP] were performed. After radiological evaluation was complete, the animals were euthanized and histological and immunohistochemical analyses were performed.
  
  
  RESULTS
  Liver function tests at different time points demonstrated no significant changes. No mortality or postoperative complications were found in any of the experimental models. Imaging studies ([MRCP], [ERCP] and Choledochoscopy with SpyGlass(™)) showed absence of stenosis or obstruction in all the experimental models.
  
  
  CONCLUSIONS
  Histological and immunohistochemical staining (CK19 and MUC5+) revealed the presence of biliary epithelium with intramural biliary glands in all the experimental models. There was no stenosis or obstruction in the bile duct.
  
  
  CONCLUSIONS
  The bioprosthesis served as scaffolding for tissue regeneration. There was no postoperative complication at 6 months follow-up. This bioprosthesis could be used to replace the bile duct in cancer or bile duct injury. The bioprosthesis may allow different modeling depending on the type of bile duct injury.
authors.affiliation: Departamento de Cirugía, Facultad de Medicina, UNAM, Mexico; Servicio de Gastroenterología, Fundación Clínica, Médica Sur, Mexico; Servicio de Cirugía General, Hospital General de México, Mexico. Electronic address: montalvoeduardo@hotmail.com.
authors.forename: Eduardo E
authors.initials: EE
authors.lastname: Montalvo-Javé
authors.affiliation: Departamento de Cirugía, Facultad de Medicina, UNAM, Mexico.
authors.forename: Germán E
authors.initials: GE
authors.lastname: Mendoza Barrera
authors.affiliation: Departamento de Cirugía, Facultad de Medicina, UNAM, Mexico.
authors.forename: Alan I
authors.initials: AI
authors.lastname: Valderrama Treviño
authors.affiliation: Laboratorio de Biomateriales, Instituto de Investigación de Materiales, UNAM, Mexico.
authors.forename: María C
authors.initials: MC
authors.lastname: Piña Barba
authors.affiliation: Departamento de Biología Celular y Tisular, Facultad de Medicina, UNAM, Mexico.
authors.forename: César
authors.initials: C
authors.lastname: Montalvo-Arenas
authors.affiliation: Servicio de Gastroenterología, Fundación Clínica, Médica Sur, Mexico.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rojas Mendoza
authors.affiliation: Departamento de Cirugía, Facultad de Medicina, UNAM, Mexico.
authors.forename: Benjamin
authors.initials: B
authors.lastname: León Mancilla
authors.affiliation: Departamento de Cirugía, Facultad de Medicina, UNAM, Mexico.
authors.forename: Manuel A
authors.initials: MA
authors.lastname: García Pineda
authors.affiliation: Departamento de Cirugía, Facultad de Medicina, UNAM, Mexico.
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Jaime Limón
authors.affiliation: Servicio de Patología, Fundación Clínica Médica Sur, Mexico.
authors.forename: Jorge
authors.initials: J
authors.lastname: Albores Saavedra
authors.affiliation: Departamento de Cirugía, Facultad de Medicina, UNAM, Mexico.
authors.forename: Jesús
authors.initials: J
authors.lastname: Tapia-Jurado
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D001705:Bioprosthesis; D002763:Cholecystectomy / Q000009:adverse effects*; D003135:Common Bile Duct / Q000293:injuries* / Q000601:surgery; D008297:Male; D019919:Prosthesis Implantation; D013552:Swine; D054457:Tissue Scaffolds
keywords: Bile duct; Bile duct injury; Bioprosthesis; Experimental surgery; Pig