Novel Silk Fibroin Based Bilayer Scaffolds for Bioabsorbable Internal Biliary Stenting.

Biliary duct reconstruction is one of the most challenging parts of liver transplantation and accounts for 40%-60% of complications. While current stent-based devices on the market show promising results in reducing complications, they are manufactured from permanent synthetic materials and require a second reintervention for their removal. This exposes the patients to other potential complications and increases healthcare costs. This study develops a fabrication technique to produce a bioabsorbable biliary stent based on silk fibroin. The process used a dip-coating procedure for silk fibroin that produced highly smooth monolayer tubular specimens without the use of any additional surfactants during removal. This process was combined with an electrospinning step to produce bilayer structures through the deposition of electrospun silk fibroin on the outer surface. The structures proved to have promising mechanical, morphological, and cytocompatibility properties for use in the field of biliary stenting. Furthermore, the technique investigated proved to be reproducible, achieving an important requirement for large-scale use even in the presence of a biomaterial derived from a natural source. These results show the possibility of obtaining a completely bioabsorbable internal biliary stent that does not require any second reintervention. This study can be the starting point for further investigations both in vitro and in vivo to assess the suitability of silk fibroin biliary stents for clinical applications.