Reliable Biodegradable Pancreatic and Biliary Stents May Be on the Horizon
Bret T. Petersen, MD, FASGE, reviewing Anderloni A, et al. Gastrointest Endosc 2020 Feb 24.
Biodegradable biliary and pancreatic stents with predictable performance would be tremendously cost-effective for many pathologies for which temporary stenting is used. In this prospective pilot study of a new helicoid stent with variable intended degradation speeds, the authors assessed stent degradation time (by abdominal x-rays) and adverse events. They also compared technical aspects of placement and fluoroscopic visualization to those of standard plastic stents.
Fifty-three biliary (64.2%) and pancreatic (35.8%) stents were placed, including 12 fast-degrading (7 days), 6 medium-degrading (20 days), and 35 slow-degrading (77 days) designs. Assessment at the approximate intended interval to degradation for each stent design (14, 21, and 84 days) demonstrated partial degradation in 48 stents (90.6%) and premature migration in 5 stents (9.4%). Assessment at approximately 2 to 4 times the intended duration to dissolution (4 weeks, 6 weeks, and 6 months) demonstrated complete degradation in 100% of stents. Fluoroscopic visualization was rated fair, good, and excellent in 5.6%, 73.6%, and 20.8% of stents, respectively. The ability to load the stents was uniformly excellent, and pushability was excellent in 90.5% and good in 7.5% of cases. Only 1 adverse event of mild post-ERCP pancreatitis occurred, and no symptoms were attributed to migration or occlusion by stent fragments.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
Anderloni A, Fugazza A, Maroni L, et al. New biliary and pancreatic biodegradable stent placement: a single-center, prospective, pilot study (with video). Gastrointest Endosc 2020 Mar 4. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2020.02.049)