Superelastic titanium nickelide stents with memory form prevent the development of cicatricial lesions of the extrahepatic bile ducts in the location of pancreatoand biliodigestive anastomoses

Surgical interventions for benign lesions of the extrahepatic bile ducts in 15-25% of cases end with the creation of bypass biliodigestive anastomoses. After pancreaticoduodenal resection, every 6 patients have failure of biliodigestive anastomoses and the formation of an external biliary fistula. During the same operation, failure of the pancreatodigestive anastomosis develops in about 15-40%, leading to high mortality. The use of traditional technologies in the surgical treatment of pancreatic pseudocysts is accompanied by the development of early complications and leads to relapses. In connection with this, interest arose in the use, for the treatment and prevention of these complications accompanying operations on the bile ducts and pancreas, of a new generation of implant materials with shape memory. From 1990 to 2021, we performed 183 stenting operations for pancreato- and biliodigestive anastomoses with titanium nickelide stents. In the comparison group of 56 patients with cicatricial lesions of the extrahepatic biliary tract, who used STPD and precision suture, good results were achieved in 58.5%, satisfactory in 22%, unsatisfactory in 19.5%. In the second comparison group of patients with this pathology, who underwent X-ray endobiliary stenitization with nitinol stents with a round thread section, good results were obtained in 41.8% of patients, satisfactory - in 58.2%. The average duration of stent functioning in this group of patients was 38.2±2.3 months. The results of treatment and prevention of the development of cicatricial lesions of the extrahepatic bile ducts of pancreato- and biliodigestive anastomoses using superelastic stents made of titanium nickelide with shape memory indicate the effectiveness and prospects of this direction both in open and laparoscopic operations.

Surgical interventions, benign lesions of the extrahepatic bile ducts, biliodigestive bypass anastomoses, stenting operations for pancreatic and biliodigestive anastomoses, titanium nickelide stents

1. Medical materials and implants with shape memory: (in 14 volumes). V. 12 / ed. V. E. Günther. - Tomsk: Izd-vo MITS, 2013. 126 p. (in Russ.)@@ Медицинские материалы и имплантаты с памятью формы: (в 14 т.). Т. 12 / под ред. В. Э. Гюнтера. - Томск: Изд-во МИЦ, 2013. - 126 с.

2. Shabunin A. V. Ways to improve the results of pancreatoduodenal resection in patients with tumors of the periampullary zone. Annals of surgical hepatology. 2006; 11(4): 69-76. (in Russ.)@@ Шабунин А. В. Пути улучшения результатов панкреатодуоденальной резекции у больных с опухолями периампулярной зоны. Анналы хирургической гепатологии. 2006; 11(4): 69-76.

3. Shtofin S.G., Anishchenko V. V., Shtofin G. S. Choice of method for correction of cicatricial lesions of extrahepatic bile ducts and biliodigestive anastomoses. Experimental and clinical gastroenterology. 2017;145(9): 74-77 (in Russ.)@@ Штофин C. Г., Анищенко В. В., Штофин Г. С. и др. Выбор способа коррекции рубцовых поражений внепеченочных желчных протоков и билиодигестивных анастомозов. Экспериментальная и клиническая гастроэнтерология. 2017;145(9): 74-77.

4. Shtofin, S.G., Shtofin A. S., Sadovsky A. S. Pancreatodigestive anastomoses on nickel-titanium stents in diseases of the pancreas. Bulletin of the East Siberian Scientific Center of the Siberian Branch of the Russian Academy of Medical Sciences. 2012.S4(86):115. (in Russ.)@@ Штофин, С.Г., Штофин А. С., Садовский А. С. Панкреатодигестивные анастомозы на никелид-титановых стентах при заболеваниях поджелудочной железы. Бюллетень Восточно-Сибирского научного центра Сибирского отделения Российской академии медицинских наук. 2012.S4(86):115.

5. Shtofin S. G., Günter V. E., Krylov A. L. et al. Patent No. 2623312 C Russian Federation, IPC A61F 2/915. Stent for the prevention of postoperative cicatricial strictures of the bile ducts: No. 2016107637: Appl. 03/02/2016: publ. 06.23.2017 / (in Russ.)@@ Патент № 2623312 C Российская Федерация, МПК A61F 2/915. Стент для профилактики постоперационных рубцовых стриктур желчных протоков: № 2016107637: заявк. 02.03.2016: опубл. 23.06.2017 / С. Г. Штофин, В. Э. Гюнтер, А. Л. Крылов и др.