Necessity and possible promising directions for creating artificial choledoch duct (literature review)

Abstract

This review is devoted to the prospect of creating an artificial choledoch duct in case of its intraoperative injuries. Currently, there is no consensus on the optimal tactics of reconstructive surgical interventions, determining indications for the formation of biliodigestive anastomoses and transhepatic drainage of the biliary tract. The quality patients’ life after reconstruction in low mortality rate in this type of surgery decreases due to recurrent cholangitis, which in the future leads to liver abscesses and cirrhosis. The first attempts of prosthetics of the common bile duct were associated with the first use of stents in surgical practice. The second stage in the study of the reconstruction of the common bile duct were attempts to use stents and patches from transplants of subcutaneous veins, urethra, vagina of the rectus abdominis, and small intestine. The third stage in the development of this direction is using stents made with fibers of biodegradable polymer compounds.

There several advantages of using biodegradable stents. Firstly, they are completely metabolized in the body and perform a skeleton function. Secondly, it is possible to use multilayer structures by means of cellular technologies that ensure the conformitythis of the model with the structures of the common bile duct. A stent from biodegradable material can be used with radiopaque dye and medications, for example, antibiotics to prevent cholangitis, or drugs supressing enhanced formation of fibrous tissue to prevent strictures.

Keywords

choledochus prosthesis / common bile duct / tissue engineering technologies

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