In Vivo Justification of Using Endobiliary Stents Made of Polyhydroxyalkanoates

Abstract

AbstractTreatment of patients with mechanical jaundice (MJ) has been one of the topical problems of current medicine. The fraction of patients having MJ of oncologic character that can undergo radical surgery does not exceed 25–30%. A way out of such situation is to use minimally invasive endobiliary interventions, the main type of which is endoprosthesis replacement of bile duct lumens. The aim of the work was to study the biological properties of the experimental models of polymer stents made of PHA for endobiliary prosthetics and to investigate the biological properties of PHA suture material for forming of biliary‐enteric anastomoses (cholecystoduodenostomy). Experiments were performed on 20 adult mongrel dogs, weighing 10–12 kg. The animals were divided to three groups: the negative control group (intact animals); the positive control group (the animals with implanted endobiliary silicon stents); and the experimental group (the animals with the PHA stents). The animals were monitored for 100 days. The clinical blood analysis was made before the operation, on day 7, 30, 60 and 100 days. During autopsy the presence of exudate, commissural process in the free abdominal cavity and subhepatic spatium, the appearance of choledoch where the prosthesis was located, as well as the appearance of cholecystoenterostomy, liver and duodenum. We did not found any signs of inflammation, cicatrical changes were estimated in the free abdominal cavity and subhepatic spatium. All implanted PHA stents were at their initial places of implantation. After the end of the experiment inflammatory reaction and anastomositis were absent. Macroscopic changes of liver and duodenum were also not detected. Liver function did not have any pathological deviations. These positive results give grounds to conclude that application of PHA as endobiliary stents in reconstructive surgery of bile passages and as suture material is a promising technology.