Novel flower-type covered metal stent to prevent cholecystitis: experimental study in a pig model

作者：Woo Young Sik; Lee Kwang Hyuck; Lee Jong Kyun^*; Noh Dong Hyo; Park Joo Kyung; Lee Kyu Taek; Jang Kee Taek

来源：Surgical Endoscopy and Other Interventional Techniques, 2016, 30(3): 1141-1145.

DOI：10.1007/s00464-015-4317-4

• Bile duct stent
• Self-expanding metal stent (SEMS)
• Flower-type covered metal stent
• Cholecystitis
• Pig model

Background Covered self-expandable metal stent (CSEMS) has the risk of obstruction of the cystic duct, and the main and branch pancreatic ducts due to strong radial force and covering material, which results in cholecystitis and pancreatitis. A flower-type covered self-expandable metal stent (F-CSEMS) having a five-petal-shaped design with side grooves was constructed to prevent the obstruction of the cystic duct orifice. This study investigated the value of the F-CSEMS in protection for cholecystitis in a pig model.
Methods Fourteen pigs randomly underwent endoscopic placement of either F-CSEMS or conventional CSEMS (C-CSEMS). The stent was placed across the cystic duct orifice to impede bile drainage from the gallbladder. Drainage was checked at 24, 48, 120 and 168 h after implantation. Blood was collected at baseline, on days 2 and 7 following implantation. The animals were killed for histologic evaluation on day 7.
Results All stents were successfully inserted into bile duct without any procedure-related complications. At 48 h, the rate of contrast drainage from the gallbladder was higher in the F-CSEMS group than the C-CSEMS group without significant difference (71.4 vs. 28.6 % p = 0.28). C-CSEMS was associated with higher levels of C-reactive protein (35.2 vs. 20.5 mu g/dl, p = 0.03) and histologic inflammatory scores of gallbladder (score 4 vs. 2; p = 0.03).
Conclusion The F-CSEMS appears safe and helpful to prevent cholecystitis without disturbance of bile flow in a pig model.

• 出版日期2016-3