Peroral cholecystoscopy–guided interventions through a lumen-apposing metal stent after EUS-guided gallbladder drainage: proof-of-concept study in a swine model

iGIE Pub Date : 2024-09-01 DOI:10.1016/j.igie.2024.07.001

Naminatsu Takahara MD, PhD , Yousuke Nakai MD, PhD , Tatsuya Sato MD, PhD , Ryunosuke Hakuta MD, PhD , Hiroki Oyama MD, PhD , Kensaku Noguchi MD, PhD , Tatsunori Suzuki MD, PhD , Kazunaga Ishigaki MD, PhD , Tomotaka Saito MD, PhD , Tsuyoshi Hamada MD, MPH, PhD , Mitsuhiro Fujishiro MD, PhD

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Abstract

Background and Aims

EUS-guided gallbladder drainage (EUS-GBD) using a lumen-apposing metal stent (LAMS), originally developed as drainage for cholecystitis, enables endoscopic access into the gallbladder lumen. However, few studies have investigated the feasibility of peroral cholecystoscopy (POCCS)-guided interventions through a LAMS.

Methods

EUS-GBD using a LAMS followed by POCCS-guided interventions were performed in 4 swine. Technical success, safety, and feasibility of POCCS visualization and POCCS-guided biopsy sampling and mucosal resection through the LAMS immediately and 3 weeks after EUS-GBD were investigated. Additionally, all specimens including necropsy were pathologically evaluated.

Results

POCCS and target biopsy sampling were successful through the LAMS in all swine immediately after EUS-GBD, without any adverse events. POCCS-guided biopsy sampling and mucosal resection 3 weeks after EUS-GBD were technically feasible and pathologically assessable in all swine. The necropsy specimens displayed hyperplastic and inflammatory changes in the gallbladder and nearby organs after 3 weeks of EUS-GBD.

Conclusions

POCCS-guided interventions including mucosal resection were technically feasible through a LAMS after EUS-GBD.

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在内镜超声引导下进行胆囊引流术后，通过腔隙贴合金属支架进行口周胆囊镜引导介入治疗：猪模型概念验证研究

背景和目的使用腔隙贴合金属支架（LAMS）的超声引导胆囊引流术（EUS-GBD）最初是作为胆囊炎的引流而开发的，它能使内镜进入胆囊腔。然而，很少有研究调查了在经口胆囊镜（POCCS）引导下通过 LAMS 进行介入治疗的可行性。方法在 4 头猪身上进行了使用 LAMS 的 EUS-GBD 和 POCCS 引导下的介入治疗。研究调查了 POCCS 可视化和 POCCS 引导下通过 LAMS 在 EUS-GBD 后立即和 3 周进行活检取样和粘膜切除的技术成功率、安全性和可行性。此外，还对包括尸体解剖在内的所有标本进行了病理评估。结果所有猪在 EUS-GBD 术后立即通过 LAMS 成功进行了 POCCS 和目标活检取样，未发生任何不良事件。所有猪在 EUS-GBD 3 周后在 POCCS 引导下进行活检取样和粘膜切除在技术上是可行的，病理学上也可进行评估。结论在 EUS-GBD 3 周后，通过 LAMS 进行包括粘膜切除在内的 POCCS 引导干预在技术上是可行的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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