Feasibility study of EUS-NOTES as a novel approach for peroral cholecysto-gastrostomy

Chirurgia (Bucur). 2013 Jan-Feb;108(1):62-9.

Abstract

Background: EUS-guided cholecysto-gastrostomy might be a useful minimally invasive procedure used for salvage drainage in advanced pancreaticobiliary cancers, but also for drainage of the gallbladder in acute cholecystitis in patients deemed unfit for laparoscopic surgery.

Objective: Direct EUS-guided cholecysto-gastrostomy with placement of a double flanged expandable metal stents.

Design/setting: This was an animal pilot/feasibility study.

Interventions: The feasibility of EUS-guided cholecysto-gastrostomy through a transgastric approach was tested in five pigs. Specially designed EUS-guided devices for initial access in the gallbladder and a double flanged expandable metal stent were used in this study.

Result: The results showed the feasibility of EUS-guided cholecysto-gastrostomy based on prototype devices for access in the gallbladder and transgastric stent placement.

Limitations: Survival feasibility study with prototype devices in a small number of animals.

Conclusions: EUS guided cholecysto-gastrostomy in a porcine model is feasible but technically demanding due to anatomical limitations of the pig and/or complexity of the procedure and the preliminary stage of development of the accessory devices.

Abbreviations: NOTES - Natural Orifice Translumenal Endoscopic Surgery; EUS - Endoscopic Ultrasound; EUSFNA - Endoscopic Ultrasound Fine Needle Aspiration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Biopsy, Fine-Needle / methods
  • Cholecystectomy / methods*
  • Disease Models, Animal
  • Endosonography*
  • Feasibility Studies
  • Gastrostomy / methods*
  • Mouth*
  • Natural Orifice Endoscopic Surgery / methods*
  • Reproducibility of Results
  • Stents
  • Sus scrofa