Recent Advances in TransplantationLiver transplantationBile Duct Anastomosis Supplied With Biodegradable Stent in Liver Transplantation: The Initial Experience

•We investigated the role of an absorbable biliary stent with the aim to prove patency of duct-to-duct biliary anastomosis.•The absorbable internal stent had good patency.•The stent was absorbed completely without any adverse effects.•Stents can be successfully and safely used in clinical practice.•Further large prospective randomized studies are needed to estimate the efficacy of the bioabsorbable stents.

BackgroundThe most common biliary complications after orthotopic liver transplantation are bile leaks, anastomotic and intrahepatic strictures, stones, and ampullary dysfunction. These complications can occur in up to 10% to 30% of liver transplant recipients. Leaks occur early in the posttransplant period; the stricture formation typically graduates over time.MethodsTen patients underwent transplantation in our preliminary study: 5 were randomized to the group with stent placement and 5 to the control group. We investigated the role of an absorbable biliary stent with the goal of proving patency of duct-to-duct biliary anastomosis. The stents are made of machine-knitted polydioxanone monofilaments.ResultsOur initial results show that duct-to-duct biliary reconstruction using an absorbable internal stent had good patency in all 5 patients. There were no signs of biliary leakage accompanying the anastomoses in any of the cases, and there was no stone formation observed after liver transplantation. The biliary stent was completely absorbed, with no adverse effects.ConclusionsBased on our initial experience and data, we concluded that biodegradable stents can be successfully and safely used in clinical practice. Further large prospective randomized studies are needed to estimate the efficacy of the bioabsorbable stents.