Superelastic titanium nickelide stents with memory form prevent the development of cicatricial lesions of the extrahepatic bile ducts in the location of pancreatoand biliodigestive anastomoses

Abstract

Surgical interventions for benign lesions of the extrahepatic bile ducts in 15-25% of cases end with the creation of bypass biliodigestive anastomoses. After pancreaticoduodenal resection, every 6 patients have failure of biliodigestive anastomoses and the formation of an external biliary fistula. During the same operation, failure of the pancreatodigestive anastomosis develops in about 15-40%, leading to high mortality. The use of traditional technologies in the surgical treatment of pancreatic pseudocysts is accompanied by the development of early complications and leads to relapses. In connection with this, interest arose in the use, for the treatment and prevention of these complications accompanying operations on the bile ducts and pancreas, of a new generation of implant materials with shape memory. From 1990 to 2021, we performed 183 stenting operations for pancreato- and biliodigestive anastomoses with titanium nickelide stents. In the comparison group of 56 patients with cicatricial lesions of the extrahepatic biliary tract, who used STPD and precision suture, good results were achieved in 58.5%, satisfactory in 22%, unsatisfactory in 19.5%. In the second comparison group of patients with this pathology, who underwent X-ray endobiliary stenitization with nitinol stents with a round thread section, good results were obtained in 41.8% of patients, satisfactory - in 58.2%. The average duration of stent functioning in this group of patients was 38.2±2.3 months. The results of treatment and prevention of the development of cicatricial lesions of the extrahepatic bile ducts of pancreato- and biliodigestive anastomoses using superelastic stents made of titanium nickelide with shape memory indicate the effectiveness and prospects of this direction both in open and laparoscopic operations.