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The development of vitally functional biliary substitutes has long been awaited. However, despite numerous approaches for replacement of biliary defects with a variety of materials, an "artificial bile duct" has not yet been realized clinically. Recently, tissue engineering has become a promising technique for regenerating defective organs. In the present study, we attempted to regenerate bile duct tissue using in situ tissue engineering. We prepared experimental scaffolds composed of collagen sponge (CS) as a base material and performed biliary reconstruction using these artificial bile ducts in canine models. We replaced circumferential biliary defects with our prosthesis in 7 dogs. In group A, we used prostheses consisting entirely of CS with biliary stenting for 2 weeks (2 dogs). In group B, the biliary stents were left in place for 12 weeks (2 dogs). In group C, we used prostheses consisting of a CS reinforced with a polypropylene (PP) mesh framework with biliary stenting for 2 weeks (3 dogs). In group A, stenosis of the prostheses progressed and the dogs became jaundiced within 2 months. In group B, regeneration of biliary epithelium was not seen, although the prostheses maintained the patency of the duct due to long-term stenting. In group C, a reconstructed bile duct composed of newly formed biliary epithelium and connective tissue successfully replaced the defects and maintained the patency without long-term stenting. Thus, our artificial bile duct consisting of CS and a PP mesh framework shows potential for regeneration of bile duct tissue.

Experimental Biliary Reconstruction with an Artificial Bile Duct Using in situ Tissue Engineering Technique