The effect of a novel drug-eluting plastic stent on biliary stone dissolution in an ex vivo bile perfusion model

BackgroundTemporary plastic stent insertion has been considered a safe and effective bridge therapy for difficult common bile duct (CBD) stones. Infusing chemicals to directly dissolve stones through the bile duct might also be effective. However, there are no studies on the efficacy of the combination of these 2 approaches.ObjectiveTo investigate the efficacy of a novel ethylenediaminetetraacetic acid (EDTA) and sodium cholate–eluting plastic stent on biliary stones.DesignEx vivo model by using different doses of active ingredient.Setting and InterventionsAn ex vivo bile duct model perfused with porcine bile was created. Stents coated with degradable membranes containing various concentrations of EDTA and sodium cholate were placed in the model with CBD stones.Main Outcome MeasurementsThe change in the weight of stents and stones was measured every week during perfusion until the coated membranes were completely biodegraded.ResultsThe time that the stents required to be fully degraded and the efficiency of stone dissolution were positively correlated with the percentage of EDTA and sodium cholate in the stent membrane. However, the 50% EDTA and sodium cholate stents achieved the greatest percentage of stone weight loss when the drugs were completely released.LimitationsEx vivo study.ConclusionsThe EDTA and sodium cholate–eluting plastic stent effectively dissolved CBD stones and has prospect in the therapy for patients with difficult CBD stones.