Klabukov ID, Baranovskii DS, Shegay PV, Kaprin AD. Pitfalls and promises of bile duct alternatives: There is plenty of room in the regenerative surgery. World J Gastroenterol 2023; 29(30): 4701-4705 [PMID: 37662863 DOI: 10.3748/wjg.v29.i30.4701]
Corresponding Author of This Article
Ilya D Klabukov, MSc, PhD, Director, Department of Regenerative Medicine, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 4 Koroleva Street, Obninsk 249036, Russia. ilya.klabukov@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 14, 2023; 29(30): 4701-4705 Published online Aug 14, 2023. doi: 10.3748/wjg.v29.i30.4701
Pitfalls and promises of bile duct alternatives: There is plenty of room in the regenerative surgery
Ilya D Klabukov, Denis S Baranovskii, Peter V Shegay, Andrey D Kaprin
Ilya D Klabukov, Denis S Baranovskii, Department of Regenerative Medicine, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk 249036, Russia
Peter V Shegay, Andrey D Kaprin, Center for Innovative Radiological and Regenerative Technologies, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, Obninsk 249036, Russia
Author contributions: Klabukov ID designed and performed research, and wrote the letter; Baranovskii DS analyzed data; Baranovskii DS, Shegay PV, and Kaprin AD revised the letter.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ilya D Klabukov, MSc, PhD, Director, Department of Regenerative Medicine, National Medical Research Radiological Center of the Ministry of Health of the Russian Federation, 4 Koroleva Street, Obninsk 249036, Russia. ilya.klabukov@gmail.com
Received: May 31, 2023 Peer-review started: May 31, 2023 First decision: July 8, 2023 Revised: July 11, 2023 Accepted: July 25, 2023 Article in press: July 25, 2023 Published online: August 14, 2023
Abstract
Current abdominal surgery has several approaches for biliary reconstruction. However, the creation of functional and clinically applicable bile duct substitutes still represents an unmet need. In the paper by Miyazawa and colleagues, approaches to the creation of bile duct alternatives were summarized, and the reasons for the lack of development in this area were explained. The history of bile duct surgery since the nineteenth century was also traced, leading to the conclusion that the use of bioabsorbable materials holds promise for the creation of bile duct substitutes in the future. We suggest three ideas that may stimulate progress in the field of bile duct substitute creation. First, a systematic analysis of the causative factors leading to failure or success in the creation of bile duct substitutes may help to develop more effective approaches. Second, the regeneration of a bile duct is delicately balanced between epithelialization and subsequent submucosal maturation within limited time frames, which may be more apparent when using quantitative models to estimate outcomes. Third, the utilization of the organism’s endogenous regeneration abilities may enhance the creation of bile duct substitutes. We are convinced that an interdisciplinary approach, including quantitative methods, machine learning, and deep retrospective analysis of the causes that led to success and failure in studies on the creation of bile duct substitutes, holds great value. Additionally, more attention should be directed towards the balance of epithelialization and submucosal maturation rates, as well as induced angiogenesis. These ideas deserve further investigation to pave the way for bile duct restoration with physiologically relevant outcomes.
Core Tip: Progress towards the development of clinically applicable bile duct substitutes can be achieved by applying an interdisciplinary approach. This approach should include the utilization of quantitative mathematical methods, principles of cross-tissue interactions for epithelial and submucosal tissues, as well as deep retrospective data analysis of the causes of success and failure in studies on the creation of bile duct substitutes.
