Magnetic compression anastomosis for treatment of biliary stricture after cholecystectomy
Ontology highlight
ABSTRACT:
SUBMITTER: Do M
PROVIDER: S-EPMC9264143 | biostudies-literature | 2022 Apr
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:PurposeThe current drain tubes for preventing surgically biliary anastomotic stricture are not naturally and easily removed. If a drain tube using biodegradable material is easily available and the degradation time of the tube is well controlled, surgical anastomotic stricture and fibrosis could be prevented. The aim of this animal study was to evaluate the preventive effect of novel biodegradable stents (BS) on biliary stricture and fibrosis after duct-to-duct (DD) biliary anastomosis.MethodsTen mini-pigs were allocated to the control group (n = 5) and or the stent group (n = 5). The common bile duct was exposed through surgical laparotomy and then resected transversely. In the stent group, a 4-mm or 6-mm polydioxanone/magnesium sheath-core BS was inserted according to the width of the bile duct, followed by DD biliary anastomosis. In the control group, DD biliary anastomosis was performed without BS insertion.ResultsIn the stent group, stents were observed without deformity for up to 4 weeks in all animals. Eight weeks later, histopathologic examination revealed that the common bile duct of the anastomosis site was relatively narrower in circumference in the control group compared to the stent group. The degree of fibrosis in the control group was more marked than in the stent group (3.84 mm vs. 0.68 mm, respectively; P < 0.05).ConclusionOur study showed that novel BS maintained their original shape and radial force for an adequate time and then disappeared without adverse events. The BS could prevent postoperative complications and strictures after DD biliary anastomosis.
| S-EPMC8831087 | biostudies-literature
Project description:Video 1Magnetic compression anastomosis for the treatment of complete gastric outlet obstruction.
| S-EPMC9174043 | biostudies-literature
Project description:PurposeMetabolic surgery remains underutilized for treating type 2 diabetes, as less invasive alternative interventions with improved risk profiles are needed. We conducted a pilot study to evaluate the feasibility of a novel magnetic compression device to create a patent limited caliber side-to-side jejunoileal partial diversion in a nonhuman primate model.Materials and methodsUsing an established nonhuman primate model of diet-induced insulin resistance, a magnetic compression device was used to create a side-to-side jejunoileal anastomosis. Primary outcomes evaluated feasibility (e.g., device mating and anastomosis patency) and safety (e.g., device-related complications). Secondary outcomes evaluated the device's ability to produce metabolic changes associated with jejunoileal partial diversion (e.g., homeostatic model assessment of insulin resistance [HOMA-IR] and body weight).ResultsDevice mating, spontaneous detachment, and excretion occurred in all animals (n = 5). There were no device-related adverse events. Upon completion of the study, ex vivo anastomoses were widely patent with healthy mucosa and no evidence of stricture. At 6 weeks post-device placement, HOMA-IR improved to below baseline values (p < 0.05). Total weight also decreased in a linear fashion (R2 = 0.97) with total weight loss at 6 weeks post-device placement of 14.4% (p < 0.05).ConclusionThe use of this novel magnetic compression device to create a limited caliber side-to-side jejunoileal anastomosis is safe and likely feasible in a nonhuman primate model. The observed glucoregulatory and metabolic effects of a partial jejunoileal bypass with this device warrant further investigation to validate the long-term glucometabolic impact of this approach.
| S-EPMC10810932 | biostudies-literature
Project description:Video 1Details regarding the patient's clinical presentation and prior endoscopic treatments for common hepatic duct stricture are first described in the video. Next, the video features footage from subsequent ERCP demonstrating the common hepatic duct stricture both fluoroscopically and endoscopically via cholangioscopy, followed by treatment with thulium laser stricturoplasty/dissection. The immediate post-treatment images of the stricture are displayed which demonstrated marked improvement in the stricture. Finally, the patient's ensuing clinical course is displayed in which the stricture recurred and was retreated with laser stricturoplasty/dissection and stent upsizing.
| S-EPMC9264140 | biostudies-literature
Project description:Video 1Magnetic compression anastomosis via EUS-guided hepaticogastrostomy for recanalization of complete common hepatic bile duct transection.
| S-EPMC8353199 | biostudies-literature
Project description:Magnetic compression anastomosis (MCA) has been appreciated as an innovative alternative to manual suturing in vascular reconstruction. However, magnetic devices have limitations in their applications. The present study aimed to introduce a newly developed magnetic device for end-to-end vascular anastomosis. Twenty male New Zealand rabbits were randomly assigned to receive end-to-end postcaval vein anastomosis using either a newly designed MCA device (Group MCA) or continuous-interrupted suturing (Group CIS). The anastomotic patency was evaluated by Doppler or venography immediately, 1 week, and 12 weeks after surgery. Anastomotic quality was evaluated gross and microscopic histological study 12 weeks after surgery. The procedure was successfully performed and all animals survived until sacrifice. The duration of surgery and anastomosis time in Group MCA were significantly shorter compared to Group CIS (all p?<?0.001), and the incidence of anastomotic patency and postoperative morbidity were comparable between the two groups (all p?>?0.05). Hematoxylin-eosin staining showed that anastomotic intima from Group MCA was much smoother with more regularly arranged endothelial cells than from compared to the Group CIS. A novel MCA device was successfully applied in rabbit vascular anastomosis. We demonstrated the reliability and effectiveness of this newly developed MCA in this study.
| S-EPMC7136200 | biostudies-literature
Project description: Not available
| S-EPMC7570430 | biostudies-literature
Project description:The large animal model with benign biliary stricture (BBS) is essential to undergo experiment on developing new devices and endoscopic treatment. This study conducted to establish a clinically relevant porcine BBS model by means of endobiliary radiofrequency ablation (RFA). Endoscopic retrograde cholangiography (ERC) was performed on 12 swine. The animals were allocated to three groups (60, 80, and 100 W) according to the electrical power level of RFA electrode. Endobiliary RFA was applied to the common bile duct for 60 seconds using an RFA catheter that was endoscopically inserted. ERC was repeated two and four weeks, respectively, after the RFA to identify BBS. After the strictures were identified, histologic evaluations were performed. On the follow-up ERC two weeks after the procedure, a segmental bile duct stricture was observed in all animals. On microscopic examination, severe periductal fibrosis and luminal obliteration with transmural inflammation were demonstrated. Bile duct perforations occurred in two pigs (100 W, n = 1; 80 W, n = 1) but there were no major complications in the 60 W group. The application of endobiliary RFA with 60 W electrical power resulted in a safe and reproducible swine model of BBS.
| S-EPMC4974186 | biostudies-literature
Project description:Hepaticojejunostomy is currently the best treatment for post-cholecystectomy biliary strictures. Laparoscopic repair has not gained popularity due to difficult reconstruction. We present case of 43-year-old-female with Bismuth type 2 stricture following laparoscopic converted open cholecystectomy with bile duct injury done elsewhere. Position was modified Llyod-Davis position and four 8-mm robotic ports (including camera) and 12-mm assistant port were placed. The procedure included noticeable steps such as adhesiolysis, identification of gallbladder fossa, identification of common hepatic duct, lowering of hilar plate etc. Operating and console time were 420 and 350 minutes and blood loss was 100 mL. Patient was discharged on postoperative day 4. Robotic repair (hepaticojejunostomy) of biliary tract stricture after cholecystectomy is safe and feasible with good outcomes.
| S-EPMC10505368 | biostudies-literature
Project description:The authors present a case of radiation-induced biliary stricture following yttrium-90 ((90)Y) radioembolization for hepatocellular carcinoma. Biliary complications (e.g., biliary stricture, biliary necrosis, biloma) following radioembolization and other locoregional therapies are uncommon and usually managed conservatively. In instances when biliary injury is refractory to medical management, as in the case presented herein, endoscopic, percutaneous, or surgical intervention may be required. Timely diagnosis of biliary complications with correlation to liver function permits optimal clinical management of patients undergoing (90)Y radioembolization.
| S-EPMC3193325 | biostudies-other