A new biodegradable stent for the pancreaticojejunal anastomosis after pancreaticoduodenal resection: In vitro examination and pilot experiences in humans

We sought to develop a biodegradable pancreatic stent that could be easily placed at operation into the human pancreatic duct and the degradation of w hich could be easily followed up. Spiral-shaped, gamma-sterilized stents we re manufactured of 0.4-mm polylactide wire in which there was added 23 weig ht-% barium sulfate. The biodegradability of the stents was studied in vitr o at two different pH values, the first resembling that of pancreatic juice and the other that of bile. The effects of enzymoactivity in the test solu tion and the composition of the stents (with or without barium addition) al so were tested. These kinds of stents have been experimented with in two pi lot patients. Degradation of the stents occurred from 24 to 52 weeks of inc ubation. Alkaline milieu together with the presence of pancreatic enzyme ma de the stents degrade twice as fast as when either alkaline milieu or enzym e was present. In the milieu resembling pancreatic juice, barium sulfate ha d no effect on the degradation time. Neither of the pilot patients had any postoperative complications. Biodegradable, x-ray-positive stents degrade f aster in pancreatic than in biliary milieu. Their safety and efficacy in hu man pancreaticojejunal anastomoses need further study.