Novel reconstruction of the extrahepatic biliary tree with a biosynthetic absorbable graft

Nau, Peter; Liu, James H.; Ellison, E. Christopher; Hazey, Jeffrey W.; Henn, Matthew C.; Muscarella, Peter; Narula, Vimal K.; Melvin, W. Scott

doi:10.1111/j.1477-2574.2011.00337.x

Cited by 15 publications

(21 citation statements)

References 15 publications

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“…14,16,17,29,30 Complete absorption of BCF has also been observed 12 weeks after implantation in the tympanic bulla of Wistar rats, and when used to replace, dura mater is gradually absorbed over a period of three months, perhaps owing to use of a thinner film. 31 Similar findings have been reported for extrahepatic ductal grafts composed of a bioabsorbable tube of polylactic acid polymer and polycaprolactone which are completely absorbed by the fourth month. 9 Bacterial cellulose for oral use in Wistar rats showed minimal cytotoxicity, 15 similarly favourable results, when BCF is used for repair of bladder, venous and dural defects.…”

Section: Discussionsupporting

confidence: 79%

Use of bacterial cellulose film for repair of bile duct injury in pigs

et al. 2020

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Background/objective The aim was to evaluate the use of bacterial cellulose film and bile duct autograft in repairing critical common bile duct injury in pigs. Methods A prospective experimental analytical study was carried out on 20 Sus Domesticus, Piau suidae swine, divided into a control group ( n = 10) and an experimental group ( n = 10) divided into two subgroups: bacterial cellulose film E1 and bacterial cellulose film E2 to which bacterial cellulose film was randomly allocated. The control group underwent two complete critical common bile duct sections 10 mm apart, while the experimental group with a single critical common bile duct defect underwent a 10 mm section of the longitudinal shaft with edge resection. The defects in the control group were treated with end-to-end conventional anastomosis using polyglycolic 6–0 surgical thread and the experimental group with bacterial cellulose film by continuous suture using the same material. The animals were clinically evaluated throughout the experiment on days D150 (bacterial cellulose film E1), D225 (control group), and D330 (bacterial cellulose film E2) and by intraoperative ultrasound examination related to histopathological and biochemical findings. Results The intraoperative ultrasonography detected the changes resulting from the common bile duct anastomosis in the control group that produced a considerable incidence of ductal narrowing and obstruction to the biliary flow. In the bacterial cellulose film E2 group, there was an increase in inflammation intensity, granulomatous reaction, fibrosis, and vessels density, without producing bile duct dilation in the ultrasonography assessment. Biochemical analysis of liver enzymes yielded results in the normal range confirming preservation of liver function at the different post-surgery time points. Conclusion Bacterial cellulose film, when used as a graft for bile duct repair, proved to be a biocompatible material that produced a complete healing process and biliary flow continuity.

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Section: Discussionsupporting

confidence: 79%

Use of bacterial cellulose film for repair of bile duct injury in pigs

et al. 2020

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“…The graft favored ingrowth of native tissues to reconstitute the bilioenteric anatomy, the majority of the bile duct being lined with columnar epithelial cells overlying collagenous connective tissue. However, complications, such as early anastomotic dehiscences, cholangitis, and stent migration, were observed in less than half of the implanted animals (5 dogs of 11) survived for the predetermined periods . Miyazawa et al obtained an artificial bile duct organoid unit (BDOU) by seeding autologous bone marrow cells on the internal lumen of a bioabsorbable polymer tube, made up of a copolymer of PCL and PLA (50:50) and reinforced with PGA fibers (5 mm diameter, 1 mm in thickness, 95% porosity and absorbed by the body in 6–8 weeks).…”

Section: Bile Ductsmentioning

confidence: 99%

“…However, complications, such as early anastomotic dehiscences, cholangitis, and stent migration, were observed in less than half of the implanted animals (5 dogs of 11) survived for the predetermined periods. 106 Miyazawa et al 107 obtained an artificial bile duct organoid unit (BDOU) by seeding autologous bone marrow cells on the internal lumen of a bioabsorbable polymer tube, made up of a copolymer of PCL and PLA (50:50) and reinforced with PGA fibers (5 mm diameter, 1 mm in thickness, 95% porosity and absorbed by the body in 6-8 weeks). BDOU, implanted as a bypass graft into the extrahepatic pig bile duct (3 cm length), resulted in bile duct regeneration, morphologically and functionally resembling the native ducts, 6 months after transplantation.…”

Section: Bile Ductsmentioning

confidence: 99%

Are synthetic scaffolds suitable for the development of clinical tissue‐engineered tubular organs?

Gaudio

Baiguera

Ajalloueian

et al. 2013

J Biomedical Materials Res

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Transplantation of tissues and organs is currently the only available treatment for patients with end‐stage diseases. However, its feasibility is limited by the chronic shortage of suitable donors, the need for life‐long immunosuppression, and by socioeconomical and religious concerns. Recently, tissue engineering has garnered interest as a means to generate cell‐seeded three‐dimensional scaffolds that could replace diseased organs without requiring immunosuppression. Using a regenerative approach, scaffolds made by synthetic, nonimmunogenic, and biocompatible materials have been developed and successfully clinically implanted. This strategy, based on a viable and ready‐to‐use bioengineered scaffold, able to promote novel tissue formation, favoring cell adhesion and proliferation, could become a reliable alternative to allotransplatation in the next future. In this article, tissue‐engineered synthetic substitutes for tubular organs (such as trachea, esophagus, bile ducts, and bowel) are reviewed, including a discussion on their morphological and functional properties. © 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 102A: 2427–2447, 2014

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“…In order to attach the autologous graft to the CDS, the graft was sutured with simple interrupted 5–0 absorbable monofilament, similarly to previous reports in which interrupted 5–0 to 6–0 absorbable or non-absorbable suture was used to patch the graft to the CBD ( 16 , 17 , 19 , 22 ). The use of sealant to prevent leakage from the grafting site was not considered, because a previous study reported that a fibrin sealant could act as an infectious nidus, causing post-grafting acute cholangitis ( 17 ). ARS grafting to the circumference of the open end of the CDS, patching of the remnant of the graft to the surrounding fibrous capsule, and traditional omental grafting were enough to seal the short CDS completely without any bile leakage form the grafting site.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Surgical Correction of a Cystic Duct Stump Leakage Following Cholecystectomy Using an Autologous Rectus Sheath Graft in a Dog

2021

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A 2.7 kg, 13-year-old, castrated male Yorkshire Terrier was presented with bile peritonitis after cholecystectomy. Exploratory coeliotomy to identify and correct bile leakage revealed that the transected end of the cystic duct was open with no in-situ ligatures or vascular clips. The residual cystic duct stump was too short to ligate or seal directly. An autologous rectus sheath graft, harvested from the internal leaf of the rectus sheath, was used to patch the cystic duct stump. The graft was secured over the open duct using several simple interrupted sutures and covered with an omentalization. The clinical signs resolved after surgery, except for a transient increase in hepatobiliary enzyme levels and intrahepatic bile duct dilatation. The enzyme levels returned to near normal on day 25 after surgery. No intrahepatic bile duct dilatation was detected on day 55 after surgery. The owner was contacted for 3 years post-operatively and reported that the dog remained healthy without any long-term complications. Grafting using autologous rectus sheath can be used to treat cystic duct stump leakage that cannot be managed with direct closure using traditional modalities due to spatial constraints.

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Novel reconstruction of the extrahepatic biliary tree with a biosynthetic absorbable graft

Abstract: Biliary reconstruction using a synthetic bioabsorbable prosthetic as an interposition tube graft is feasible based on initial results.

Cited by 15 publications

References 15 publications

Use of bacterial cellulose film for repair of bile duct injury in pigs

Use of bacterial cellulose film for repair of bile duct injury in pigs

Are synthetic scaffolds suitable for the development of clinical tissue‐engineered tubular organs?

Case Report: Surgical Correction of a Cystic Duct Stump Leakage Following Cholecystectomy Using an Autologous Rectus Sheath Graft in a Dog

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