Fluoroscopy-Guided Gastrojejunostomy Creation with Lumen-Apposing Metal Stent in a Porcine Model
- PDF / 1,754,815 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 28 Downloads / 164 Views
LABORATORY INVESTIGATION
NON-VASCULAR INTERVENTIONS
Fluoroscopy-Guided Gastrojejunostomy Creation with LumenApposing Metal Stent in a Porcine Model Jingui Li1 • Tao Gong1 • Jiaywei Tsauo1 • He Zhao1 • Xiaowu Zhang1 Mingchen Sang1 • Xiao Li1
•
Received: 31 March 2020 / Accepted: 26 June 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Purpose To evaluate the technical feasibility of fluoroscopy-guided gastrojejunostomy creation in a porcine model. Methods Eight domestic female pigs (median, 15.6 kg; range, 14.5–16.3 kg) were included in this study. The proximal jejunum was punctured from the stomach using a Ro¨sch–Uchida Transjugular Liver Access Set through the mouth, and a lumen-apposing metal stent was placed across the puncture tract between the stomach and the proximal
Jingui Li and Tao Gong have contributed equally to this work and are co-first authors. & Jiaywei Tsauo [email protected] Jingui Li [email protected] Tao Gong [email protected] He Zhao [email protected] Xiaowu Zhang [email protected] Mingchen Sang [email protected]
jejunum. All animals were euthanized 6 weeks after the procedure. Results The fistulous tract creation and stent insertion with confirmed patency were successful in eight animals, rendering a technical success rate of 100%. Gross inspection showed a matured and patent fistulous tract between the stomach and the proximal jejunum in seven animals. In one animal, the colon between the stomach and the proximal jejunum was inadvertently punctured followed by migration of the stent from the stomach into the colon after the procedure to form a delayed jejunocolostomy. A stent migration and an inadvertent traversing the tail of pancreas by the stent were observed in another two animals without signs of bleeding, infection, or pancreatitis. All animals survived until the end of this study without change in their behavior or appetite. Histological analysis showed that all the fistulous tracts had matured with continuity of submucosal, muscular, and serosal layers, and without destruction of epithelial layers. Conclusions Fluoroscopy-guided gastrojejunostomy creation is technically feasible in a porcine model but requires refinement of the targeting technique to avoid transgression of nontarget organs. Keywords Gastric outlet obstruction Endosonography Gastric bypass Prostheses and implants
Xiao Li [email protected] 1
Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Chaoyang District, Beijing 100021, China
123
J. Li et al.: Fluoroscopy-Guided Gastrojejunostomy Creation with Lumen-Apposing…
Introduction Surgical gastrojejunostomy (GJ) has traditionally been the mainstay of treatment for malignant gastric outlet obstruction (GOO) [1]. However, endoscopic or fluoroscopic self-expandable metalli
Data Loading...
