Safety and efficacy of a novel plastic stent coated with stone-dissolving agents for the treatment of biliary stones in a porcine model

Endoscopy. 2015 May;47(5):457-61. doi: 10.1055/s-0034-1390772. Epub 2014 Dec 5.

Abstract

Background and study aim: We previously reported on a plastic stent that was coated with ethylenediaminetetraacetic acid (EDTA) and sodium cholate, which dissolved common bile duct (CBD) stones ex vivo. The aim of this study was to investigate the safety and efficacy of such stents on biliary stones in a live porcine model.

Methods: Stents without coating or with degradable membranes containing 0 % or 50 % EDTA and sodium cholate were inserted together with human CBD stones into the porcine CBD. Serum laboratory variables, histological examinations of the bile duct, and the weight change in stones were compared during and after stent placement for 6 months.

Results: A total of 16 pigs were included (5 no coating, 5 0 % coating, 6 50 % coating). Biliary stones showed decreased weight in all groups; however, stones in the group with 50 % coated stents showed a greater reduction in weight compared with the no coating and the 0 % coating groups (269 ± 66 mg vs. 179 ± 51 mg [P = 0.09]; 269 ± 66 mg vs. 156 ± 26 mg [P = 0.01], respectively).

Conclusions: The plastic stent coated with 50 % agent enhanced CBD stone dissolution in vivo and may be a promising tool for patients with difficult biliary stones.

MeSH terms

  • Alanine Transaminase / blood
  • Amylases / blood
  • Animals
  • Aspartate Aminotransferases / blood
  • Calcium Chelating Agents / administration & dosage*
  • Cholangiography
  • Disease Models, Animal
  • Drug-Eluting Stents* / adverse effects
  • Edetic Acid / administration & dosage*
  • Gallstones / blood
  • Gallstones / diagnostic imaging
  • Gallstones / therapy*
  • Leukocyte Count
  • Plastics
  • Sodium Cholate / administration & dosage*
  • Swine

Substances

  • Calcium Chelating Agents
  • Plastics
  • Edetic Acid
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Amylases
  • Sodium Cholate