Successful treatment of a benign biliary stricture with biodegradable metallic biliary stents

Abstract

Background: A 19 year old boy from a UNHCR camp presented to our hospital with an insidious onset of painless jaundice without any constitutional symptoms. Biochemical and ultrasonograph confirmed obstructive jaundice. Tumor markers, brush cytology and infective parameters were all negative. We successfully treated the symptoms with a biodegradable metallic biliary stent. Methods: Pre-procedural MRCP confirmed presence of benign stricture at distal CBD with dilated biliary systems. We obtained consent to deploy a 10mm diameter x 40mm length Biodegradable Balloon Expandable Biliary Stent System (QualiMed Innovative Medizinprodukte GmbH, Germany) across the stricture via ERCP. It is a flexible, magnesium based stent pre-mounted on the balloon of an over-the-wire (OTW) stent delivery system. Results: Patient's symptom resolved. We performed a repeat MRCP and ERCP at 10 months. The stent has been fully degraded. There was no residual stricture and patient remained clinically and biochemically not jaundiced. The radial strength of the biodegradable biliary stent support and maintained the patency across the distal biliary stricture. It provided a controlled delayed degradation over time. The stent has a good fluoroscopic visibility with minimal foreshortening. Conclusion: The usability and mechanical properties of the Biodegradable Balloon Expandable Biliary Stent System are comparable to regular metalic stent systems, but with the advantage of fully degraded and leaving nothing behind.