Remodeling of strain energy function of common bile duct post obstruction.

Abstract

Biliary duct obstruction is an important clinical condition that affects millions of people worldwide. We have previously shown that the common bile duct (CBD) undergoes significant growth and remodelling post obstruction. The mechanical stress-strain relation is expected to change due to growth and remodeling in response to obstruction and hence pressure-overload. The objective of the present study was to characterize the material properties of the CBD of the sham group and at 3 hours, 12 hours, 2 days, 8 days and 32 days (n=5 in each group) after obstruction. The Fung's exponential strain energy function was used to relate stress to strain of the normal and remodeled ducts. The Marquardt-Levenberg and genetic algorithm methods were used for the determination of material constants for the exponential strain energy function. The elastic constants obtained by the two methods did not differ (p>0.254). We obtained stable and convergent material constants at every time point. The material constant that dictates the nonlinear rate of change in the circumferential stress with respect to strain increased significantly after obstruction acutely in the first 12 hrs., decreased at 2 days and finally increased montonically during the remaining 30 days. The acute initial increase in stiffness was simply due to the elastic response. The chronic remodeling process results in an initial circumferential softening followed by stiffening of the CBD. This study has important clinical significance for patients with CBD obstruction and for endoscopists and surgeons who treat the condition.