Endoscopic-assisted laser sphincterotomy of the intramural common bile duct: A cadaveric pilot study.

IF 1.3 2区 农林科学 Q2 VETERINARY SCIENCES
Hiroshi Miyagi, Galina M Hayes
{"title":"Endoscopic-assisted laser sphincterotomy of the intramural common bile duct: A cadaveric pilot study.","authors":"Hiroshi Miyagi, Galina M Hayes","doi":"10.1111/vsu.14280","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To (1) develop a minimally invasive technique for endoscopic-assisted retrograde catheterization (EARC) of the major duodenal papilla (MDP) in dogs and (2) pilot a safe method of endoscope-guided laser sphincterotomy of the intramural segment of the common bile duct (ICBD).</p><p><strong>Study design: </strong>Descriptive study.</p><p><strong>Animals: </strong>Twenty fresh canine cadavers.</p><p><strong>Methods: </strong>Following mini-midline celiotomy and exteriorization of the distal duodenum, endoscopy of the duodenal lumen was performed under saline irrigation via a 5 mm cuffed endoscopic port using a 2.7 mm 30° rigid cystoscope and HoYag laser fiber. Endoscopic-assisted retrograde catheterization of the MDP and laser sphincterotomy extended to the end of the ICBD was performed. The duodenal segment was dissected under magnification following the endoscopic procedure. The length of the ICBD and the incidence of iatrogenic injury were recorded.</p><p><strong>Results: </strong>The EARC of the MDP and laser sphincterotomy were successful in 18 of 18 attempts. The ICBD segments ranged from 10 to 21 mm long (n = 20) (body weight 6.6-37.0 kg). There was no correlation between body weight and length of the ICBD (Pearson's rho = .06, p = .79). Partial thickness lateral perforations occurred in two specimens. Division of the submucosal layer during ablation heralded the start of the extramural segment and could be identified consistently (16/18; 88%).</p><p><strong>Conclusion: </strong>Endoscopic-assisted retrograde catheterization and extended laser sphincterotomy appeared feasible and safe in canine cadavers. Further evaluation in a live-animal setting is warranted.</p><p><strong>Clinical significance: </strong>Endoscopic-assisted retrograde catheterization may have advantages over current open techniques for accessing the duodenal papilla and endoscopic laser sphincterotomy may assist resolution of ICBD obstructions.</p>","PeriodicalId":23667,"journal":{"name":"Veterinary Surgery","volume":" ","pages":""},"PeriodicalIF":1.3000,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Veterinary Surgery","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.1111/vsu.14280","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To (1) develop a minimally invasive technique for endoscopic-assisted retrograde catheterization (EARC) of the major duodenal papilla (MDP) in dogs and (2) pilot a safe method of endoscope-guided laser sphincterotomy of the intramural segment of the common bile duct (ICBD).

Study design: Descriptive study.

Animals: Twenty fresh canine cadavers.

Methods: Following mini-midline celiotomy and exteriorization of the distal duodenum, endoscopy of the duodenal lumen was performed under saline irrigation via a 5 mm cuffed endoscopic port using a 2.7 mm 30° rigid cystoscope and HoYag laser fiber. Endoscopic-assisted retrograde catheterization of the MDP and laser sphincterotomy extended to the end of the ICBD was performed. The duodenal segment was dissected under magnification following the endoscopic procedure. The length of the ICBD and the incidence of iatrogenic injury were recorded.

Results: The EARC of the MDP and laser sphincterotomy were successful in 18 of 18 attempts. The ICBD segments ranged from 10 to 21 mm long (n = 20) (body weight 6.6-37.0 kg). There was no correlation between body weight and length of the ICBD (Pearson's rho = .06, p = .79). Partial thickness lateral perforations occurred in two specimens. Division of the submucosal layer during ablation heralded the start of the extramural segment and could be identified consistently (16/18; 88%).

Conclusion: Endoscopic-assisted retrograde catheterization and extended laser sphincterotomy appeared feasible and safe in canine cadavers. Further evaluation in a live-animal setting is warranted.

Clinical significance: Endoscopic-assisted retrograde catheterization may have advantages over current open techniques for accessing the duodenal papilla and endoscopic laser sphincterotomy may assist resolution of ICBD obstructions.

内窥镜辅助下胆总管激光括约肌切开术:一项尸体试验研究。
目的:(1)建立犬十二指肠乳头内镜下逆行置管术(EARC)的微创技术;(2)探索内镜引导下胆总管内段激光括约肌切开术的安全方法。研究设计:描述性研究。动物:20具新鲜的狗尸体。方法:在微创中线切除十二指肠后,采用2.7 mm 30°刚性膀胱镜和HoYag激光光纤,经5 mm带口盐水冲洗十二指肠腔镜。内窥镜辅助下逆行置管MDP和激光括约肌切开术延伸至ICBD末端。十二指肠段在内镜下放大切开。记录ICBD的长度和医源性损伤的发生率。结果:18次手术中18次成功切除了MDP和激光括约肌切开术。ICBD节段长10 ~ 21mm (n = 20)(体重6.6 ~ 37.0 kg)。体重与ICBD长度之间没有相关性(Pearson’s rho =)。06, p = .79)。在两个标本中出现了部分厚度的侧向穿孔。消融过程中粘膜下层的分裂预示着外段的开始,并且可以一致地识别(16/18;88%)。结论:内窥镜辅助下逆行置管和扩大激光括约肌切开术在犬尸体中是可行和安全的。有必要在活体动物环境中进行进一步评估。临床意义:内镜辅助下逆行置管在进入十二指肠乳头方面可能比目前的开放技术有优势,内镜下激光括约肌切开术可能有助于解决ICBD阻塞。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Veterinary Surgery
Veterinary Surgery 农林科学-兽医学
CiteScore
3.40
自引率
22.20%
发文量
162
审稿时长
8-16 weeks
期刊介绍: Veterinary Surgery, the official publication of the American College of Veterinary Surgeons and European College of Veterinary Surgeons, is a source of up-to-date coverage of surgical and anesthetic management of animals, addressing significant problems in veterinary surgery with relevant case histories and observations. It contains original, peer-reviewed articles that cover developments in veterinary surgery, and presents the most current review of the field, with timely articles on surgical techniques, diagnostic aims, care of infections, and advances in knowledge of metabolism as it affects the surgical patient. The journal places new developments in perspective, encompassing new concepts and peer commentary to help better understand and evaluate the surgical patient.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信