Biliary Tract Diseases Clinical Trial
Official title:
Endoscopic Treatment of Benign Biliary Strictures and Cystic Duct Leakages With a Novel Biodegradable Polydioxanone Biliary Stent
Patients with either post-cholecystectomy bile leak or benign biliary stricture are recruited for endoscopic insertion of a biodegradable biliary stent. A follow-up of 12 months with repeated serum samples and magnetic resonance imaging is scheduled. The primary end points are feasibility of endoscopic insertion with the novel implantation device and stricture or leak resolution as well as clinical treatment success.
Benign biliary strictures (BBS) and post-cholecystectomy bile leaks have traditionally been
treated endoscopically with plastic stents. In BBS, promising results of covered
self-expanding metal stent use have been recently published. However, in both BBS and
post-cholecystectomy bile leak the need of stent therapy is temporary and endoscopic stent
exchange or removal is unavoidable. These two groups of patients may be the ones that would
most obviously benefit from biodegradable (BD) biliary stents. Studies of BD stents on animal
models have shown excellent long term patency and safety both in biliary and pancreatic duct
as well better outcome compared to plastic stents after post-cholecystectomy bile leak in an
animal study. Until recently, non-operative insertion of BD polydioxanone stent in human
biliary tract has been possible only via percutaneous route.
With the novel implantation device, the BD stents (braided, self-expanding polydioxanone
stent, 8 x 40-60mm, Ella, Czech republic) may be used endoscopically during endoscopic
retrograde cholangio-pancreatography (ERCP).
The hypothesis is that larger diameter and radial expansion strength provide at least similar
treatment success as the current method of endoscopic insertion of plastic or covered
self-expanding metal stents in bile leak and BBS, respectively. However, later stent exchange
or removal is not necessary with BD stents.
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