Background and Aims

EUS-guided gallbladder drainage (EUS-GBD) is a challenging technique for endoscopists that requires a high level of skill. EUS-GBD is challenging because the gallbladder can be easily collapsed. To resolve this issue, we aimed to develop a retrievable puncture anchor traction (RPAT) method for EUS-GBD. We evaluated and compared the success rate, safety, and outcomes of the RPAT method for EUS-GBD against EUS-GBD without RPAT using a porcine model.

Methods

In total, 16 Bama mini pigs (weighing 15-20 kg) were randomly divided into an experimental group (n = 8) and a control group (n = 8). The RPAT method was performed in the experimental group and EUS-GBD without retrievable puncture anchor was performed in the control group. Incidence of operative adverse events, wound healing, and success rates of EUS-GBD were compared and analyzed between the experimental group and the control group.

Results

All EUS-GBD procedures were successfully performed in all 8 animals in the experimental group (100%). However, in the control group, EUS-GBD was successfully performed only on 4 pigs (50%); the remaining 4 pigs died because of EUS-GBD failure caused by gallbladder collapse leading to unsuccessful frontal stent release.

Conclusions

RPAT helped increase the success rate of EUS-GBD and could reduce gallbladder collapse. Therefore, we believe this method can be applied to EUS-GBD in the near future. Furthermore, RPAT will enhance the safety of EUS-GBD.

中文翻译：

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EUS引导胆囊引流的可取式穿刺锚固牵引方法：一项猪研究

背景和目标

EUS引导胆囊引流术（EUS-GBD）对内镜医师而言是一项具有挑战性的技术，需要高水平的技能。EUS-GBD具有挑战性，因为胆囊很容易塌陷。为解决此问题，我们旨在为EUS-GBD开发可检索的穿刺锚固牵引（RPAT）方法。我们评估并比较了使用猪模型的针对EUS-GBD的RPAT方法与不采用RPAT的EUS-GBD的成功率，安全性和结果。

方法

将总共​​16头巴马小型猪（体重15-20公斤）随机分为实验组（n = 8）和对照组（n = 8）。RPAT方法在实验组中进行，而EUS-GBD在无可取回穿刺锚的情况下在对照组中进行。在实验组和对照组之间对手术不良事件的发生率，伤口愈合和EUS-GBD的成功率进行了比较和分析。

结果

实验组中的所有8只动物均成功执行了所有EUS-GBD程序（100％）。但是，在对照组中，仅对4头猪（50％）成功地进行了EUS-GBD。其余4头猪因胆囊塌陷导致EUS-GBD衰竭而导致额叶支架释放失败而死亡。

结论

RPAT帮助提高EUS-GBD的成功率，并可以减少胆囊衰竭。因此，我们相信该方法可以在不久的将来应用于EUS-GBD。此外，RPAT将增强EUS-GBD的安全性。