An extrahepatic bile duct grafting using a bioabsorbable polymer tube
Masayasu Aikawa1, Mitsuo Miyazawa, Kojun Okamoto
1Gastrointestinal Center, Department of Surgery, Saitama Medical University, International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan. aikawama@ybb.ne.jp
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.
Conclusion:
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.
