Non-Newtonian Bile Flow in Elastic Cystic Duct: One- and Three-Dimensional Modeling

The impact of choledochal cysts on bile fluid dynamics: A perspective using computational fluid dynamics and surface mapping technique

Choledochal cysts (CCs) are an important risk factor for cholangiocarcinoma, though their etiology remains debated. Given the vital role of bile fluid in digestive processes within the biliary system, examining such mechanisms from the perspective of bile fluid dynamics may offer additional insights for clinical use. This study utilized magnetic resonance imaging (MRI)-based patient-specific scans for detailed reconstruction and further employed the computational fluid dynamic method to assess the physiological functions of each system, including refilling and emptying processes. The impact of bile rheological property was also examined. Key biomechanical parameters—pressure and wall shear stress (WSS)—were displayed on a two-dimensional plane via surface mapping for enhanced visualization and comparative analysis. Outcomes demonstrated a significant reduction in bile flow velocity in CCs patients due to common bile duct's anatomical features and bile's shear-thinning, non-Newtonian nature, with a notable increase in pressure drop observed. In healthy biliary systems, WSS variations were minimal; however, in CCs patients, extreme WSS differences were found, with the highest WSS in the segmental bile duct and the lowest in the dilatation area, presenting a magnitude difference of approximately 1000. CCs one showed WSS levels 100–250 times higher than healthy ones in the common bile duct. Bile rheological properties substantially affect pressure and WSS patterns, particularly WSS, where pathological bile caused a tenfold increase in WSS compared to healthy bile. The findings aimed to enhance the understanding of biliary fluid mechanics in CCs and offer insights into selected fluidic variables for future microfluidic chip experiments.

Review on bile dynamics and microfluidic-based component detection: Advancing the understanding of bilestone pathogenesis in the biliary tract

Bilestones are solid masses found in the gallbladder or biliary tract, which block the normal bile flow and eventually result in severe life-threatening complications. Studies have shown that bilestone formation may be related to bile flow dynamics and the concentration level of bile components. The bile flow dynamics in the biliary tract play a critical role in disclosing the mechanism of bile stasis and transportation. The concentration of bile composition is closely associated with processes such as nucleation and crystallization. Recently, microfluidic-based biosensors have been favored for multiple advantages over traditional benchtop detection assays for their less sample consumption, portability, low cost, and high sensitivity for real-time detection. Here, we reviewed the developments in bile dynamics study and microfluidics-based bile component detection methods. These studies may provide valuable insights into the bilestone formation mechanisms and better treatment, alongside our opinions on the future development of in vitro lithotriptic drug screening of bilestones and bile characterization tests.

The behavior between fluid and structure from coupling system of bile, bile duct, and polydioxanone biliary stent: A numerical method

The performance and effects of 12 different structures of stents in the bile duct were compared and used the finite element method. Numerical models of the 12 kinds of fluid-structure interaction(FSI) coupling systems were established to investigate the relationship between three aspects (velocity distribution of bile, wall shear stress (WSS) distribution of bile, and Von Mises Stress(VMS) distribution on the stent and bile duct) and the structural parameters of the stent (monofilament diameter and the number of braiding heads). After calculating and analyzing the simulation results yielding distributions of velocity, WWS, and VMS and regions of bile duct susceptibility to stenosis, they were consistent with previous findings on the locations of restenosis occurring after stent removal, indicating that the simulation results could provide a useful reference for studying biliary stents. The results of the simulations showed that (i) eddy currents were prone to occur at the stent ends regions; (ii) the WSS distribution of the bile fluid in contact with the stent and bile duct related to the stent structure; (iii) the high VMS on the stent and bile duct was prone to occur at the stent ends. The simulation results of 12 FSI coupling systems were studied and two superior stent model structures were obtained by comprehensive evaluation.

In silico modeling for the hepatic circulation and transport: From the liver organ to lobules

The function of the liver depends critically on its blood supply. Numerous in silico models have been developed to study various aspects of the hepatic circulation, including not only the macro-hemodynamics at the organ level, but also the microcirculation at the lobular level. In addition, computational models of blood flow and bile flow have been used to study the transport, metabolism, and clearance of drugs in pharmacokinetic studies. These in silico models aim to provide insights into the liver organ function under both healthy and diseased states, and to assist quantitative analysis for surgical planning and postsurgery treatment. The purpose of this review is to provide an update on state-of-the-art in silico models of the hepatic circulation and transport processes. We introduce the numerical methods and the physiological background of these models. We also discuss multiscale frameworks that have been proposed for the liver, and their linkage with the large context of systems biology, systems pharmacology, and the Physiome project. This article is categorized under: Metabolic Diseases > Computational Models Metabolic Diseases > Biomedical Engineering Cardiovascular Diseases > Computational Models.

Environmental, Microbiological, and Immunological Features of Bacterial Biofilms Associated with Implanted Medical Devices

The spread of biofilms on medical implants represents one of the principal triggers of persistent and chronic infections in clinical settings, and it has been the subject of many studies in the past few years, with most of them focused on prosthetic joint infections. We review here recent works on biofilm formation and microbial colonization on a large variety of indwelling devices, ranging from heart valves and pacemakers to urological and breast implants and from biliary stents and endoscopic tubes to contact lenses and neurosurgical implants. We focus on bacterial abundance and distribution across different devices and body sites and on the role of environmental features, such as the presence of fluid flow and properties of the implant surface, as well as on the interplay between bacterial colonization and the response of the human immune system.

Design and Optimization of a New Anti-reflux Biliary Stent With Retractable Bionic Valve Based on Fluid-Structure Interaction Analysis

Duodenal biliary reflux has been a challenging common problem which could cause dreadful complications after biliary stent implantation. A novel anti-reflux biliary stent with a retractable bionic valve was proposed according to the concertina motion characteristics of annelids. A 2D equivalent fluid-structure interaction (FSI) model based on the axial section was established to analyze and evaluate the mechanical performances of the anti-reflux biliary stent. Based on this model, four key parameters (initial shear modulus of material, thickness, pitch, and width) were selected to investigate the influence of design parameters on anti-reflux performance via an orthogonal design to optimize the stent. The results of FSI analysis showed that the retrograde closure ratio of the retractable valve primarily depended on initial shear modulus of material (p < 0.05) but not mainly depended on the thickness, pitch, and width of the valve (p > 0.05). The optimal structure of the valve was finally proposed with a high retrograde closing ratio of 95.89%. The finite element model revealed that the optimized anti-reflux stent possessed improved radial mechanical performance and nearly equal flexibility compared with the ordinary stent without a valve. Both the FSI model and experimental measurement indicated that the newly designed stent had superior anti-reflux performance, effectively preventing the duodenobiliary reflux while enabling the bile to pass smoothly. In addition, the developed 2D equivalent FSI model provides tremendous significance for resolving the fluid-structure coupled problem of evolution solid with large deformation and markedly shortens the calculation time.

Patient-specific fluid-structure interaction model of bile flow: comparison between 1-way and 2-way algorithms

Gallbladder disease is one of the most spread pathologies in the world. Despite the number of operations dealing with biliary surgery increases, the number of postoperative complications is also high. The aim of this study is to show the influence of the biliary system pathology on bile flow character and to numerically assess the effect of surgical operation (cholecystectomy) on the fluid dynamics in the extrahepatic biliary tree, and also to reveal the difference between 1-way and 2-way FSI algorithms on the results. Moreover, the bile viscosity and biliary tree geometry influence on the choledynamics were evaluated. Bile velocity, pressure, wall shear stress (WSS), displacements and von Mises stress distributions in the extrahepatic biliary tree are presented, and comparison is made between a healthy and a lithogenic bile. The patient-specific biliary tree model is created using magnetic resonance imaging (MRI) and imported in a commercial finite element analysis software. It is found that in the case of lithogenic bile, velocities have lower magnitude while pressures are higher. Furthermore, stress analysis of the bile ducts shows that the WSS distribution is found mostly prevailing in the common hepatic duct and common bile duct areas. It is shown that when it is necessary to evaluate the bile flow dynamics in urgent medical situations, 1-way analysis is acceptable. Nevertheless, 2-way FSI provides more accurate data, if necessary to evaluate the stress-strain state of bile ducts. The proposed model can be applied to medical practice to reduce the number of post-operative complications.

Propulsion of an elastic filament in a shear-thinning fluid

Some micro-organisms and artificial micro-swimmers propel at low Reynolds numbers (Re) via the interaction of their flexible appendages with the surrounding fluid. While their locomotion has been extensively studied with a Newtonian fluid assumption, in realistic biological environments these micro-swimmers invariably encounter rheologically complex fluids. In particular, many biological fluids such as blood and different types of mucus have shear-thinning viscosities. The influence of this ubiquitous non-Newtonian rheology on the performance of flexible swimmers remains largely unknown. Here, we present a first study to examine how shear-thinning rheology alters the fluid-structure interaction and hence the propulsion performance of elastic swimmers at low Re. Via a simple elastic swimmer actuated magnetically, we demonstrate that shear-thinning rheology can either enhance or hinder elastohydrodynamic propulsion, depending on the intricate interplay between elastic and viscous forces as well as the magnetic actuation. We also use a reduced-order model to elucidate the mechanisms underlying the enhanced and hindered propulsion observed in different physical regimes. These results and improved understanding could guide the design of flexible micro-swimmers in non-Newtonian fluids.

Design and evaluation of a novel anti-reflux biliary stent with cone spiral valve

Endoscopic placement of biliary stent is a well-established palliative treatment for biliary obstruction. However, duodenobiliary reflux after stent placement has been a common problem which may lead to dreadful complications. This paper designed a novel anti-reflux biliary stent with a cone spiral valve. Fluid-Structure Interaction (FSI) simulations were established to evaluate the efficiency of the anti-reflux stent comparing with a clinically applied standard stent. According to the stress distribution of the valve, the fatigue performance in the stress concentration area was analyzed. The results show that when the antegrade flow through the valve, the cone spiral valve could stretch and open to realize adequate drainage under the normal physiological pressure of biliary tract; When the duodenal reflux through the valve, the valve would be compressed and close with a result of nearly zero at the outlet flow rate. Furthermore, the anti-reflux stent achieved improved radial mechanical performance with 2.7 times higher radial stiffness than standard stent. Finite element analysis (FEA) also indicates that compared with the standard stent, the addition of the anti-reflux valve had little negative effect on flexibility of the stent. Fatigue analysis results showed that the valve was reliable. This research provides the new stent with a cone spiral valve and proves that it is technically feasible and effective for preventing the duodenobiliary reflux while ensuring the antegrade bile flow without compromising the other biomechanical performances.

Porcine bile viscosity is proportional to density

BACKGROUND

The gallbladder filling and emptying cycle controls bile flow into the duodenum. Disruption of this emptying and refilling cycle leads to bile stasis and subsequent gallstone formation. The bile flow rate is inversely proportional to its viscosity. Moreover, bile is a complex material with varying density in different people because of its diverse components. These density changes alter the viscosity. Prediction of shear viscosity from density measurements may thus contribute to medical assessment and treatment of the patient.

OBJECTIVE

To investigate the relationship between the shear viscosity and density of bile.

METHODS

Natural and filtered bile samples were prepared for density, viscosity and pressure drop measurements. The density and shear viscosity were measured by a density meter and viscometer, respectively, and a relationship was established between them. Measurements of the pressure drop in a glass tube were used to estimate the apparent viscosity and compared with shear viscosity obtained with the viscometer.

RESULTS

The natural bile with higher density showed a greater shear viscosity than the filtered bile, especially at low shear rates. Bile viscosity was proportional to density. In addition, the pressure drop of the natural samples was greater than that of the filtered sample. The viscosity measured by the viscometer deviated from the results obtained using Poiseuille's law and the tube pressure drop measurements. The density difference between the natural and filtered bile samples was smaller than 1%. However, the viscosities of the natural and filtered bile samples varied by up to >30%.

CONCLUSIONS

Porcine bile viscosity is proportional to density. Based on the bile density, one can easily evaluate the shear viscosity using a linear relationship. The density considerably influences the bile viscosity, with small density increases greatly increasing the shear viscosity.

Experimental Investigation of the Flow of Bile in Patient Specific Cystic Duct Models

Three-dimensional scaled-up transparent models of three human cystic ducts were prepared on the basis of anatomical specimens. The measurement of pressure drop across the cystic duct models and visualization of the flow structures within these ducts were performed at conditions replicating the physiological state. The flow visualization study confirmed the laminar nature of the flow of bile inside the cystic duct and values of pressure drop coefficient (Cp) decreased as the Reynolds number (Re) increased. The three tested models showed comparable behavior for the curve of Reynolds number versus the pressure drop coefficient. The results show that the tested cystic ducts have both increased pressure drop and complicated flow structures when compared with straight conduits. High resistance in a cystic duct may indicate that the gallbladder has to exert large force in expelling bile to the cystic duct. For patients with diseased gallbladder, and even in healthy persons, gallbladder is known to stiffen with age and it may lose its compliance or flexibility. A high resistance cystic duct coupled with a stiffened gallbladder may result in prolonged stasis of bile in the gallbladder, which is assumed to encourage the formation of gallstones.