A Novel Bioabsorbable Covered Stent for Advancing Bile Duct Injury Management: A Preclinical Study in a Porcine Model (With Video)

Self-expandable metallic and plastic stents have been used for biliary tract injuries, but they are not entirely adequate as treatments. This study investigated the potential of our novel self-expandable bioabsorbable covered stent (SEBCS) to treat bile duct injuries. We developed a novel SEBCS by covering a self-expandable bioabsorbable stent with a bioabsorbable tube. Five pigs underwent laparotomy after being placed under general anesthesia. A 5-mm incision was made in the extrahepatic bile duct, followed by the insertion of an SEBCS. Postoperatively, hepatobiliary enzyme levels were measured. At 10 weeks postoperatively, a histological evaluation of the injured area and cholangiogram were performed. The SEBCS was successfully inserted into the extrahepatic bile ducts of all animals. The histological evaluation at 10 weeks postoperatively showed epithelial regeneration with numerous peribiliary glands, including at the injury site. Cholangiography revealed no stenosis in the injured area. Hematological and biochemical analyses revealed mild elevation of biliary enzyme levels on day 10 postoperatively compared with preoperative levels; these levels returned to preoperative values by week 10. This novel SEBCS technique demonstrated the potential to regenerate bile ducts at the site of extrahepatic bile duct injury and may be a promising endoscopic treatment for biliary tract injuries.