Minimizing invasiveness of hepatobiliary pancreatic disease treatment by extrahepatic bile duct regeneration-applying tissue engineering-

For more than 100 years, many studies have been conducted to develop bile duct substitute (BDS) that can replace the bile duct with the aim of preserving the nipple, but to date, no long-term functioning alternative has been developed. At this conference, we would like to describe the research status of our BDS and the prospects for the near future.(Extrahepatic bile duct regeneration by tissue engineering (TE)) We regenerate the extrahepatic bile duct in a ring shape using a bioabsorbable tube (BDS: bioabsorption period 6-8 weeks). It was successful (Am J Transplant 2005). BDS was able to directly repair the bile duct injury (Surgery 2010). Circular replacement of the injured bile duct was possible (J Gastrointest Surg. 2012). Bile duct regeneration was possible in the infected lesion (Int Surg 2015). Expected results have been obtained for these clinical applications. Currently, we are investigating the possibility of direct repair of bile duct injury by BDS, replacement with BDS after excision of small area bile duct cancer, and reduction surgery of hilar cholangiocarcinoma using BDS.(Problems of BDS research and prospects for the near future) The problem is that the control method for the bile duct regeneration and the wound healing process has not been established at present. In the near future, it seems possible to achieve minimal invasiveness in hepatobiliary and pancreatic surgery by developing these control methods and ABD for bile duct regeneration.