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Experimental study on the friction effect of plastic stents for biliary stone fragmentation (with video)
Author(s) -
Kwon ChangIl,
Kim Gwangil,
Jeong Seok,
Choi Sung Hoon,
Ko Kwang Hyun,
Lee Don Haeng,
Cho Joo Young,
Hong Sung Pyo
Publication year - 2018
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12906
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , bile duct , surgery , fragmentation (computing) , pancreatitis , computer science , operating system
Background and Aim In patients with irretrievable or intractable bile duct stone, temporary insertion of a plastic stent ( PS ) followed by further endoscopic retrograde cholangiopancreatography ( ERCP ) or surgery has been recommended as a ‘bridge’ therapy. However, the exact mechanism of stone fragmentation has not been discovered. The aim of the present study was to evaluate whether PS shape can facilitate stone fragmentation. Methods Using a new in vitro bile flow phantom model, we compared the friction effect among three different PS groups (straight PS group, double pigtail‐shaped PS group, and screw‐shaped PS group) and a control group. Each group had 10 silicon tube blocks that separately contained one stone and two PS . The control group had 10 blocks each with only a stone and no PS . We carried out analysis of the friction effect by stone weight and volume changes among the groups, excluding fragmented stones. Results After 8 weeks, complete fragmentation was noted in one out of 34 cholesterol stones (2.9%) and in four out of six pigmented stones (66.7%). Fragmentation tended to be more prominent in the screw‐shaped PS group than in the straight PS group, double pigtail‐shaped group, and control group (volume change: −11.33%, 7.94%, 4.43%, and 2.05%, respectively, P = 0.1390; weight change: −9.30%, 0.71%, −0.10%, and −1.23%, respectively, P = 0.3553). Conclusion Stone fragmentation may be induced by PS friction effect. Also, screw‐shaped plastic stents may improve friction effect. These results may help guide future PS development and clinical decisions.