An artificial bile duct made of bioabsorbable polymer: a viable substitute for narrowed portion of the extrahepatic bile duct

Abstract

Objective: The aim of this study was to investigate whether an artificial bile duct made of bioabsorbable polymer could serve as a substitute for narrowed portions of the bile duct. Methods: The experiments were performed using hybrid pigs (n = 11). After laparotomy under general anesthesia, the extrahepatic bile duct was identified and ligated around the confluence with the cystic duct. A week later, the animals were re-laparotomized and the bile duct on the hepatic side of the ligature was resected. The cut end was connected to the duodenum using a bioabsorbable artificial bile duct fabricated from a copolymer of polycaprolactone and polylactic acid fibers. The grafts were recovered for gross, histological, and blood chemical studies at 4 months after the surgery. Results: All recipient pigs survived until sacrifice for collection of the implants. A week of ligation of the extrahepatic bile duct dilated the duct to about 1 cm in diameter and increased total bilirubin. Total bilirubin had returned to the pre-implantation level in all animals at 4 months post-implantation. Examinations of the grafts revealed complete freedom of stricture and the regeneration of a neo-bile duct of about 1 cm in diameter from the graft site in 10 of 11 animals. Gross observation of the graft from the 1 remaining animal revealed stricture at the anastomosis site and poor bile duct epithelization. Conclusions: We have concluded that this bioabsorbable polymer bile duct can serve as a replacement for narrowed portions of the bile duct.