Takao Itoi1, Fumihide Itokawa1, Toshio Uraoka2, Takuji Gotoda1, Joichiro Horii2, Osamu Goto2, Fuminori Moriyasu1, Jong Ho Moon3, Yuko Kitagawa4, Naohisa Yahagi2. 1. Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. 2. Division of Research and Development for Minimally Invasive Treatment, Cancer Center, School of Medicine, Keio University, Tokyo, Japan. 3. Department of Gastroenterology, Soon Chun Hyang University School of Medicine, Seoul, Korea. 4. Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.
Abstract
BACKGROUND: Surgical gastrojejunostomy is associated with relatively high morbidity and mortality rates. However, current experimental EUS-guided gastrojejunostomy information is limited. OBJECTIVE: To evaluate a novel EUS-guided gastrojejunostomy technique using a new enteric balloon and lumen-apposing metal stent. DESIGN: Animal experiment. SETTING: Animal laboratory at a referral center. SUBJECTS AND INTERVENTIONS: In 5 pigs, gastrojejunostomies were created under EUS guidance. Fully covered lumen-apposing stents were placed between the stomach and the jejunum. MAIN OUTCOME MEASUREMENTS: Technical success and adverse events of EUS-guided gastrojejunostomy. RESULTS: All stents, with 1 exception, were successfully deployed without any adverse events. The mean time to stent placement was 44.2 minutes (range 28-64 minutes). All animals showed normal eating behavior without signs of infection for 1 month after the procedure. Endoscopic imaging of the stomach site showed the stent to be patent and stable, without dislodgment, in all of the pigs. Necropsy showed complete adhesion between the stomach and the jejunum wall. LIMITATIONS: Pilot study. CONCLUSIONS: Creation of an EUS-guided gastrojejunostomy by using a novel enteric balloon and metal stent appears to be promising as a minimally invasive treatment.
BACKGROUND: Surgical gastrojejunostomy is associated with relatively high morbidity and mortality rates. However, current experimental EUS-guided gastrojejunostomy information is limited. OBJECTIVE: To evaluate a novel EUS-guided gastrojejunostomy technique using a new enteric balloon and lumen-apposing metal stent. DESIGN: Animal experiment. SETTING: Animal laboratory at a referral center. SUBJECTS AND INTERVENTIONS: In 5 pigs, gastrojejunostomies were created under EUS guidance. Fully covered lumen-apposing stents were placed between the stomach and the jejunum. MAIN OUTCOME MEASUREMENTS: Technical success and adverse events of EUS-guided gastrojejunostomy. RESULTS: All stents, with 1 exception, were successfully deployed without any adverse events. The mean time to stent placement was 44.2 minutes (range 28-64 minutes). All animals showed normal eating behavior without signs of infection for 1 month after the procedure. Endoscopic imaging of the stomach site showed the stent to be patent and stable, without dislodgment, in all of the pigs. Necropsy showed complete adhesion between the stomach and the jejunum wall. LIMITATIONS: Pilot study. CONCLUSIONS: Creation of an EUS-guided gastrojejunostomy by using a novel enteric balloon and metal stent appears to be promising as a minimally invasive treatment.
Authors: Stuart K Amateau; Chin Hong Lim; Nicholas M McDonald; Mustafa Arain; Sayeed Ikramuddin; Daniel B Leslie Journal: Obes Surg Date: 2018-05 Impact factor: 4.129
Authors: Yen-I Chen; Takao Itoi; Todd H Baron; Jose Nieto; Yamile Haito-Chavez; Ian S Grimm; Amr Ismail; Saowanee Ngamruengphong; Majidah Bukhari; Gulara Hajiyeva; Ahmad S Alawad; Vivek Kumbhari; Mouen A Khashab Journal: Surg Endosc Date: 2016-11-10 Impact factor: 4.584