104 Evaluation of the Biodegradable Biliary Stent to Reduce Morbidity in Choledochotomy Bile Duct Exploration

Abstract Aim Evaluate use of biodegradable biliary stent in outcomes following choledochotomy bile duct exploration (BDE). Method Retrospective analysis comparing all choledochotomy BDE undertaken from 2023-2025. Primary outcome considers rate of bile leak. Secondary outcome includes pancreatitis, operative time and length of stay. Results 33 cases were undertaken; 26 had primary closure alone. Q3 Medical Archimedes stents were placed intra-operatively with use of guide wire, to facilitate drainage of the biliary tree, prior to primary closure of choledochotomy in 7 patients. Bile leak was much reduced in the stent group (31% vs 14% p=0.64). Leak was managed conservatively in the stent group. Five unstented patients required ERCP, four unstented patients returned to theatre. One patient required return to theatre three times. One patient, who was not stented, developed pancreatitis post procedure, however this was ERCP related. Although the two groups were similar in terms of gender, age, BMI, operative urgency and approach, average bile duct size was significantly higher in the stented group (12.8 vs 15.3mm p=0.049). Notably, stent insertion was attempted but not possible in one patient. Stent insertion was associated with a non-significant increase in operative time (173 vs 222 minutes, p=0.18). However, overall length of stay was shorter in the stent group, (8 vs 5days) and in the specific post-operative period (5 vs 4 days), this was not significant. Conclusions Archimedes stent insertion is associated with reduction in bile leak rate and subsequent reintervention. Insertion does not significantly increase operative time and has been shown to reduce length of stay.