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Title: New biliary endoprosthesis less liable to block in biliary infections: Description and in vitro studies
Authors: Cetta, F.
Rappuoli, R.
Montalto, G.
Baldi, C.
Gori, M.
Cetta, D.
Zuckermann, M.
Magnani, Agnese 
Barbucci, Rolando
Keywords: biliary endoprostheses; bacterial overgrowth; new biomaterial pupa; brown stones
Issue Date: 1999
Project: None 
Objective: To test in vitro stents made from a new biomaterial that is less liable to encourage adhesion of bacteria that may leadto blockage of the stent.Design: Laboratory experiment.Setting: University hospital, Italy.Material: 15 polyethylene biliary endoprostheses that had been removed endoscopically a mean of 151 days (range 55–416)after insertion. PUPA, a biomaterial that contains polyamidoamine cross-linked to polyurethane chains. This can bind largequantities of heparin and HyalSx (hyaluronic acid at a different stage of sulphation) in a stable fashion.Main outcome measures: Incidence of blockage and growth of pathogens in the polyethylene biliary prostheses. Adhesion ofpathogens to PUPA in vitro on electron microscopy.Results: 12 of 15 polyethylene prostheses were blocked by brown concretions composed of calcium bilirubinate, palmitate, andlittle cholesterol. All concretions grew more than one pathogen, and the growth always included Escherichia coli. Of the 5PUPA stents tested, only 1 had bacteria sticking to their surfaces.Conclusion: These results confirm previous studies that showed that HyalSx appreciably inhibited the adhesion of bacteria andis therefore a suitable material for the manufacture of biliary stents.
ISSN: 1102-4151
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