Pitfalls and promises of bile duct alternatives:A narrative review  

作　　者：Mitsuo Miyazawa Masayasu Aikawa Junpei Takashima Hirotoshi Kobayashi Shunsuke Ohnishi Yoshito Ikada 

机构地区：[1]Department of Surgery,Teikyo University Mizonokuch Hospital,Kanagawa 213-8507,Japan [2]Department of Surgery,Saitama Medical University International Medical Center,Saitama 350-1298,Japan [3]Department of Gastroenterology and Hepatology,Hokkaido University Faculty of Medicine and Graduate School of Medicine,Sapporo 060-8638,Japan [4]Department of Bioenvironmental Medicine,Nara Medical University,Nara 634-8521,Japan

出　　处：《World Journal of Gastroenterology》2022年第39期5707-5722,共16页世界胃肠病学杂志（英文版）

基　　金：Supported by the Japan Society for the Promotion of Science,No.21K08786。

摘　　要：Biliodigestive anastomosis between the extrahepatic bile duct and the intestine for bile duct disease is a gastrointestinal reconstruction that abolishes duodenal papilla function and frequently causes retrograde cholangitis.This chronic inflammation can cause liver dysfunction,liver abscess,and even bile duct cancer.Although research has been conducted for over 100 years to directly repair bile duct defects with alternatives,no bile duct substitute(BDS)has been developed.This narrative review confirms our understanding of why bile duct alternatives have not been developed and explains the clinical applicability of BDSs in the near future.We searched the PubMed electronic database to identify studies conducted to develop BDSs until December 2021 and identified studies in English.Two independent reviewers reviewed studies on large animals with 8 or more cases.Four types of BDSs prevail:Autologous tissue,non-bioabsorbable material,bioabsorbable material,and others(decellularized tissue,3D-printed structures,etc.).In most studies,BDSs failed due to obstruction of the lumen or stenosis of the anastomosis with the native bile duct.BDS has not been developed primarily because control of bile duct wound healing and regeneration has not been elucidated.A BDS expected to be clinically applied in the near future incorporates a bioabsorbable material that allows for regeneration of the bile duct outside the BDS.

关 键 词：Bile duct alternative Bile duct substitute Biliary regeneration Bile duct reconstruction Peribiliary gland Bioabsorbable polymer 

分 类 号：R657.4[医药卫生—外科学]