Cell-free scaffold for regenerating defective bile ducts

Abstract Much research has focussed on restoring the defective part of the gastrointestinal tract, which is considered the best way to preserve function. However, to date, no method for reconstructing the gastrointestinal tract has been developed. Here, we report a bile duct replacement method that does not require cell culture and that replaces defective bile ducts thus enabling bile duct regeneration without stenosis. The bioabsorbable bile duct substitute (BDS) (artificial bile duct (ABD); absorption period of 6–8 weeks) that we have developed is capable of reliably regenerating bile ducts, including Y-shaped bile ducts, without attaching cells to the ABD, and it can regenerate the bile duct without stenosis. Bile duct regeneration occurred in the lateral part of the ABD after the ABD passed into the duodenum. Immature cells that regenerated the bile ducts adhered to the outside of the ABD, and the adhered cell clusters formed peribiliary glands, which regenerated as mature bile duct epithelium. Furthermore, cells that adhered to the outside of the ABD regenerated bile duct epithelial cells, peribiliary glands, and fibromuscular layers into structures similar to those of the native bile duct. These results indicate that the use of this bioabsorbable BDS to restore the bile duct is a minimally invasive treatment that preserves function in the hepato-biliary-pancreatic area.