Reliable Biodegradable Pancreatic and Biliary Stents May Be on the Horizon

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.