Mitsuo Miyazawa, MD, FACS1, Masayasu Aikawa, MD2, Yasumitsu Hirano1, Kaizo Taniguchi1, Shozo Fujino1. 1Teikyo University Mizonokuchi Hospital, 2Saitama Medical University International Medical Center
Background and aim: In recent years, due to the spread of laparoscopic cholecystectomy, bile duct injury as its complication has been reported at a certain frequency. Current surgical treatments include 1) suturing and closing the injured part laparoscopically during surgery, 2) transitioning to laparotomy and closing the suture, 3) inserting a tube such as T-tube under the laparotomy, 4) bile duct-intestinal anastomosis under the laparotomy, etc. are taken into consideration. Regardless of which treatment method, it is not a definite ideal treatment. We have developed a bioabsorbable material (caprolactone: lactic acid (50: 50) polymer reinforced with polyglycolic acid fiber and designed to be absorbed in about 8 weeks). At this conference, we would like to talk about the current state and problems of development of minimally invasive therapy for biliary damaged area using bioabsorbable materials we developed.
Method: In order to overcome the problem of the current bile duct injury cure method, we have been developed, a) a method of closing a perforation part endoscopically from the luminal side of a bile duct (a covered stent using a bioabsorbable material in the damaged part), b) Develop a method of closing the biliary duct injury under the laparoscope from the outside of the bile duct (adhering the bioabsorbable sheet to the bile duct perforation using a biocompatible adhesive).
Results: Experimental results of suturing the bioabsorbable material in the biliary duct in surgery of laparotomy were able to regenerate the bile duct without stenosis in the damaged area. However, various adhesives were tried to bond the sheet of this bioabsorbable material and the native bile duct under the endoscope, but at the moment, there is no glue that will allow the sheet to be adhered readily and reliably where there is moisture to a certain extent. A tool for delivering the sheet from the bile duct into the injured part is under development and good results are obtained at present.
Conclusion: It is possible to regenerate the bile duct without constriction using a bioabsorbable material. It is difficult to laparoscopically adhere to the injured part of the bile duct, but we hope that it will be possible in the near future to develop further adhesives.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 85284
Program Number: P115
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster