scholarly journals Progress and Current Limitations of Materials for Artificial Bile Duct Engineering

Materials ◽  
2021 ◽  
Vol 14 (23) ◽  
pp. 7468
Author(s):  
Qiqi Sun ◽  
Zefeng Shen ◽  
Xiao Liang ◽  
Yingxu He ◽  
Deling Kong ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Bile Duct ◽  
Tissue Regeneration ◽  
Bile Ducts ◽  
Gastrointestinal Surgery ◽  
Bile Leakage ◽  
Biologically Active ◽  
Comprehensive Collection ◽  
Unidirectional Flow ◽  
Reflux Cholangitis

Bile duct injury (BDI) and bile tract diseases are regarded as prominent challenges in hepatobiliary surgery due to the risk of severe complications. Hepatobiliary, pancreatic, and gastrointestinal surgery can inadvertently cause iatrogenic BDI. The commonly utilized clinical treatment of BDI is biliary-enteric anastomosis. However, removal of the Oddi sphincter, which serves as a valve control over the unidirectional flow of bile to the intestine, can result in complications such as reflux cholangitis, restenosis of the bile duct, and cholangiocarcinoma. Tissue engineering and biomaterials offer alternative approaches for BDI treatment. Reconstruction of mechanically functional and biomimetic structures to replace bile ducts aims to promote the ingrowth of bile duct cells and realize tissue regeneration of bile ducts. Current research on artificial bile ducts has remained within preclinical animal model experiments. As more research shows artificial bile duct replacements achieving effective mechanical and functional prevention of biliary peritonitis caused by bile leakage or obstructive jaundice after bile duct reconstruction, clinical translation of tissue-engineered bile ducts has become a theoretical possibility. This literature review provides a comprehensive collection of published works in relation to three tissue engineering approaches for biomimetic bile duct construction: mechanical support from scaffold materials, cell seeding methods, and the incorporation of biologically active factors to identify the advancements and current limitations of materials and methods for the development of effective artificial bile ducts that promote tissue regeneration.

Management of Common Bile Duct Injury during Partial Gastrectomy

2009 ◽  
Vol 75 (8) ◽  
pp. 719-721 ◽  
Author(s):  
Jennifer A. Dixon ◽  
Katherine A. Morgan ◽  
David B. Adams
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Negative Impact ◽  
Gastrointestinal Surgery ◽  
Partial Gastrectomy ◽  
Bile Leakage ◽  
Stricture Formation ◽  
Ulcer Disease ◽  
Presenting Symptoms ◽  
Cbd Injury

Injury to the common bile duct (CBD) during upper gastrointestinal surgery for peptic ulcer disease is a serious complication with an underestimated prevalence in light of the few cases reported in the surgical literature. Three cases of CBD injury were referred to a multidisciplinary specialized gastrointestinal unit for management over a 4-year period. Anomalous anatomy, adhesions, and potential duodenal shortening secondary to contracture all predispose the biliary ducts to intraoperative injury. The axial nature of the blood supply to the extrahepatic ducts and the tendency of bile itself to cause rapid collagen turnover and fibrosis, combined with the inflammation and subsequent fibrosis to the surrounding tissues caused by bile leakage, give the bile ducts a high propensity for stricture formation. Frequently presenting symptoms of CBD injury immediately after surgery include jaundice, elevated bilirubin values, elevated t-tube drainage, and symptoms of sepsis. The most common complaints noted in patients who present in a delayed manner are symptoms of cholangitis. Even when injuries are rapidly identified and corrected, the potential for lasting negative impact on quality of life is great in many cases. When CBD injury occurs, the pancreatic duodenal union can be concomitantly disrupted.

scholarly journals Results of surgical treatment of extrahepatic bile duct injuries

2020 ◽  
Vol 37 (1) ◽  
pp. 63-72
Author(s):  
L. P. Kotelnikova ◽  
I. G. Burnyshev ◽  
O. V. Bazhenova ◽  
D. V. Trushnikov
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Surgical Treatment ◽  
Bile Duct ◽  
Bile Ducts ◽  
Bile Leakage ◽  
Biliary Reconstruction ◽  
Long Term Outcomes ◽  
Endoscopic Retrograde ◽  
Extrahepatic Bile Ducts

Aim. To evaluate the short-and long-term outcomes after surgical repair of iatrogenic lesions of extrahepatic bile ducts depending on the timing of diagnosis in conditions of specialized clinic. Materials and methods. Our study involved a retrospective analysis of 159 patients who were treated for iatrogenic lesions of extrahepatic bile ducts during 1987-2017. These patients were divided into two groups depending on the timing of surgical treatments: early biliary reconstruction ( 5 days after bile duct transection) and late biliary reconstruction ( 5 days post-transection). These groups were compared on the basis of postoperative morbidity and long-term outcomes. Results. Following laparoscopic cholecystectomy, 2 patients received endoscopic retrograde stents due to bile leakage from the cystic ducts, and 14 patients underwent hepaticocholedochostomy using Ker drainage. The incidence of bile leakage was observed in 14. 3 % of cases during the early post-operative period, strictures appeared in 28.6 % of cases. Hepaticojejunostomy was performed in 91 cases: in 62 with stents and in 29 without stents. Bile leakage was observed in 17.6 % of cases, and strictures in 19.8 % of cases. Our statistical analyses revealed no significant differences between the two groups (i.e., early and late timing of surgical treatment) in the rates of bile leakage and strictures. The extent of surgeons experience in bile surgery significantly correlated with positive outcomes. Conclusions. Endoscopic retrograde stent proved to be an effective and fast solution in cases of bile leakage from cystic ducts following laparoscopic cholecystectomy. Although it is preferable to perform reconstructive surgeries within the first five days after bile duct injury, our results indicated that in the presence of external bile fistula without peritonitis and severe cholangitis, reconstructive surgery can be performed in specialized surgical departments later than 5 days with satisfactory results.

DAMAGE TO THE BILE DUCTS AFTER LAPAROSCOPIC CHOLECYSTECTOMY. REVIEW.

2021 ◽  
pp. 17-25
Author(s):  
Maxat Doskhanov
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Ducts ◽  
Gallstone Disease ◽  
Abdominal Cavity ◽  
Bile Leakage ◽  
Treatment And Prevention ◽  
Technical Errors ◽  
Bile Duct Injuries ◽  
Good Cosmetic

This article provides a review of the literature on bile duct injuries after laparoscopic cholecystectomy. Laparascopy is considered the gold standard in the treatment of gallstone disease. This technique has a number of positive advantages: minimally invasiveness, quick rehabilitation, a shorter hospital stay, a good cosmetic effect, and a low lethal outcome. Along with these advantages, the number of complications also increased: damage to the bile ducts, hepatic vessels, bile leakage, formation of strictures, defects in drainage of the biliary tract and improper treatment of the cystic duct, insufficient drainage of the abdominal cavity. Today, many aspects of surgical treatment and prevention of bile duct injuries remain controversial and are still considered relevant. The main reasons for this complication are: lack of experience of the surgeon, inattention, ignorance of the main options and possible anomalies of important anatomical structures in the area of the hepatic hilum and hepato-duodenal ligament, technical errors.

scholarly journals An Extremely Rare Bile Leakage: Aberrant Bile Duct in Left Triangular Ligament (Appendix Fibrosa Hepatis)

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
İhsan Yıldız ◽  
Yavuz Savaş Koca ◽  
Sezayi Kantar
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Bile Duct ◽  
Magnetic Resonance ◽  
Female Patient ◽  
Bile Ducts ◽  
Bile Leakage ◽  
Resonance Imaging ◽  
Surgical Interventions ◽  
Aberrant Bile Duct

Background. The anatomical variability of bile ducts can leave surgeons in very difficult conditions.Ultrasonography, computed tomography, magnetic resonance imaging (MRCP) and endoscopic imaging methods are used in diagnosis. In addition to conservative approaches, endoscopic procedures and laparoscopic or open surgical interventions may be necessary for treatment. In this article, we present a case of aberrant bile duct in left triangular ligament (appendix fibrosa hepatis), which is rarely seen. Case. We report the case of a 67-year-old female patient who was operated on due to dumping syndrome symptoms and hiatal hernia. There was a drainage of bile from the left side of the liver which was placed under the cardioesophageal junction. MRCP found bile esophageal in the left triangular ligament of the liver. Aberrant bile ducts were found in the left triangular ligament and ligated. The patient was discharged on the 7th day after operation. Conclusion. The anatomical variability of bile ducts can leave surgeons in very difficult conditions. We recommend that the dissected left triangular ligament should be ligated for the aberrant bile duct, especially in female patient.

A Genetic Basis for Design of Biomaterials for In Situ Tissue Regeneration

2008 ◽  
Vol 377 ◽  
pp. 151-166 ◽  
Author(s):  
Larry L. Hench ◽  
Julia M. Polak
Keyword(s):  
Tissue Engineering ◽  
Tissue Regeneration ◽  
Genetic Basis ◽  
First Generation ◽  
Scar Tissue ◽  
Biologically Active ◽  
Bioactive Glasses ◽  
Osteoprogenitor Cells ◽  
New Generation

Historically the function of biomaterials has been to replace diseased, damaged and aged tissues. First generation biomaterials, including bio ceramics, were selected to be as inert as possible in order to minimize the thickness of interfacial scar tissue. Bioactive glasses provided an alternative from the 1970’s onward; second generation bioactive bonding of implants with tissues and no interfacial scar tissue. This chapter reviews the discovery that controlled release of biologically active Ca and Si ions from bioactive glasses leads to the up-regulation and activation of seven families of genes in osteoprogenitor cells that give rise to rapid bone regeneration. This finding offers the possibility of creating a new generation of gene activating bioceramics designed specially for tissue engineering and in situ regeneration of tissues.

scholarly journals A Promising Method for Repairing Low-Level Biliary Strictures After Cholecystectomy

2015 ◽  
Vol 100 (6) ◽  
pp. 1072-1077 ◽  
Author(s):  
Zhilei Cheng ◽  
Xiaoqiang Huang ◽  
Jiahong Dong
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Bile Ducts ◽  
Hepatic Duct ◽  
Gastric Wall ◽  
Bile Leakage ◽  
Gastric Fistula ◽  
Low Level ◽  
Bile Duct Repair ◽  
A New Technique

The purpose of this study is to introduce and evaluate a new technique of repairing bile ducts by the tubular gastric wall with a vascularized pedicle. Both the end-to-end bile duct repair and Roux-en-Y hepatoenterostomy have limitations in the treatment of benign bile duct strictures after cholecystectomy. There are no other good choices to manage these cases, especially the bile duct transection injuries or partly missing common bile duct or hepatic duct. Eleven patients with partly missing common bile ducts in the Chinese People's Liberation Army General Hospital between January 2007 and December 2012 were retrospectively analyzed. The study comprised 8 females and 3 males, whose age ranged from 29 to 56 years. All patients underwent successful bile duct repair. The time of operations ranged from 210 minutes to 240 minutes. The maximal blood loss was less than 220 ml. There was no perioperative mortality and no case of gastric fistula. Postoperative complications occurred in 3 patients, including wound infection, bile leakage, and erosive gastritis. All complications were cured by conservative treatment. The mean follow-up time was 42 months. One patient was classified as Terblanche's grade II and 10 patients were classified as Terblanche's grade I. The observations indicate that this technique is a feasible and effective choice to manage low level biliary stricture after cholecystectomy, especially suitable to repair bile duct transection injuries or partly missing common bile duct or hepatic duct.

Decellularized bone extracellular matrix in skeletal tissue engineering

2020 ◽  
Vol 48 (3) ◽  
pp. 755-764
Author(s):  
Benjamin B. Rothrauff ◽  
Rocky S. Tuan
Keyword(s):  
Tissue Engineering ◽  
Bone Regeneration ◽  
Tissue Regeneration ◽  
Animal Studies ◽  
Tumor Resection ◽  
Regenerative Capacity ◽  
Skeletal Tissue ◽  
Large Bone

Bone possesses an intrinsic regenerative capacity, which can be compromised by aging, disease, trauma, and iatrogenesis (e.g. tumor resection, pharmacological). At present, autografts and allografts are the principal biological treatments available to replace large bone segments, but both entail several limitations that reduce wider use and consistent success. The use of decellularized extracellular matrices (ECM), often derived from xenogeneic sources, has been shown to favorably influence the immune response to injury and promote site-appropriate tissue regeneration. Decellularized bone ECM (dbECM), utilized in several forms — whole organ, particles, hydrogels — has shown promise in both in vitro and in vivo animal studies to promote osteogenic differentiation of stem/progenitor cells and enhance bone regeneration. However, dbECM has yet to be investigated in clinical studies, which are needed to determine the relative efficacy of this emerging biomaterial as compared with established treatments. This mini-review highlights the recent exploration of dbECM as a biomaterial for skeletal tissue engineering and considers modifications on its future use to more consistently promote bone regeneration.

Regenereation in periodontics

2018 ◽  
Author(s):  
Murtaza Kaderi ◽  
Mohsin Ali ◽  
Alfiya Ali ◽  
Tasneem Kaderi
Keyword(s):  
Tissue Engineering ◽  
Clinical Practice ◽  
Periodontal Disease ◽  
Disease Progression ◽  
Tissue Regeneration ◽  
Surgical Procedures ◽  
Periodontal Regeneration ◽  
Guided Tissue Regeneration ◽  
Periodontal Tissues ◽  
Extensive Documentation

The goals of periodontal therapy are to arrest of periodontal disease progression and to attain the regeneration of the periodontal apparatus. Osseous grafting and Guided tissue regeneration (GTR) are the two techniques with the most extensive documentation of periodontal regeneration. However, these techniques offer limited potential towards regenerating the periodontal tissues. Recent surgical procedures and application of newer materials aim at greater and more predictable regeneration with the concept of tissue engineering for enhanced periodontal regeneration and functional attachment have been developed, analyzed, and employed in clinical practice

Lactoferrin in Bone Tissue Regeneration

2020 ◽  
Vol 27 (6) ◽  
pp. 838-853 ◽  
Author(s):  
Madalina Icriverzi ◽  
Valentina Dinca ◽  
Magdalena Moisei ◽  
Robert W. Evans ◽  
Mihaela Trif ◽  
...  
Keyword(s):  
Bone Tissue ◽  
Tissue Regeneration ◽  
Bone Cells ◽  
Bone Diseases ◽  
Biologically Active Compounds ◽  
Biologically Active ◽  
Bone Tissue Regeneration ◽  
Bone Homeostasis ◽  
Active Compounds

: Among the multiple properties exhibited by lactoferrin (Lf), its involvement in bone regeneration processes is of great interest at the present time. A series of in vitro and in vivo studies have revealed the ability of Lf to promote survival, proliferation and differentiation of osteoblast cells and to inhibit bone resorption mediated by osteoclasts. Although the mechanism underlying the action of Lf in bone cells is still not fully elucidated, it has been shown that its mode of action leading to the survival of osteoblasts is complemented by its mitogenic effect. Activation of several signalling pathways and gene expression, in an LRPdependent or independent manner, has been identified. Unlike the effects on osteoblasts, the action on osteoclasts is different, with Lf leading to a total arrest of osteoclastogenesis. : Due to the positive effect of Lf on osteoblasts, the potential use of Lf alone or in combination with different biologically active compounds in bone tissue regeneration and the treatment of bone diseases is of great interest. Since the bioavailability of Lf in vivo is poor, a nanotechnology- based strategy to improve the biological properties of Lf was developed. The investigated formulations include incorporation of Lf into collagen membranes, gelatin hydrogel, liposomes, loading onto nanofibers, porous microspheres, or coating onto silica/titan based implants. Lf has also been coupled with other biologically active compounds such as biomimetic hydroxyapatite, in order to improve the efficacy of biomaterials used in the regulation of bone homeostasis. : This review aims to provide an up-to-date review of research on the involvement of Lf in bone growth and healing and on its use as a potential therapeutic factor in bone tissue regeneration.

Placental Therapy as Panacea: An Insight to Its Therapeutic Potential

2020 ◽  
Vol 06 ◽  
Author(s):  
Sayed Md Mumtaz ◽  
Madhu Gupta ◽  
Ramesh K. Goyal
Keyword(s):  
Tissue Regeneration ◽  
Therapeutic Potential ◽  
Biologically Active ◽  
Bioactive Components ◽  
Biochemical Mechanisms ◽  
Clinically Significant ◽  
Available Information ◽  
Clinical Potential ◽  
Placental Extract

Abstract:: The placenta that maintains and regulates the growth of fetus, consists of various biological treasures nutrients such as cytomedines, vitamins, trace elements, amino acids, peptides, growth factors and other biologically active constituents. Their therapeutic usefulness can well define in the terms of biochemical mechanisms of various components present in it. Biomedical waste derived extract is also a panacea for treatment of various diseases. Placental therapy has been reported specifically to have potent action on recovery of diseases and tissue regeneration. Placental bioactive components and their multi targeting identity prompted us to compile the précised information on placental extract products. However, some findings are needed to be explored by scientific community to prove their clinical potential with clinically significant statistical conclusions. In the light of available information and the usefulness of the placental extract, it is necessary for the development of various formulations for various unmet meet for the treatment as well as access their adverse effects as well as contradictions and precisely evaluated in the short and in the long-term periods.

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