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A new minimally invasive porcine model for the study of intrahepatic bile duct dilatation

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Abstract

Background

Endoscopic ultrasound (EUS) procedures are becoming more frequent nowadays and novel techniques are on the rise. These procedures require high technical experience and complex endoscopic skills. The goal of this study was to develop a new minimally invasive animal model of bile duct dilatation in the pig, in order to offer a new tool for endoscopic and surgical therapy training and to test new therapeutic strategies.

Methods

Twenty-five female pigs underwent laparoscopic surgery in order to perform a common hepatic duct ligation. A pre- and postoperative biochemical analyses were performed: glucose, albumin, total bilirubin (TBil), gamma glutamyl transferase (GGT), alkaline phosphatase, and alanine aminotransferase were measured. Surgical time and intra- and postoperative complications were registered. Five to six days after surgery, an EUS was performed to measure intrahepatic duct size (mm). Distance from the bile duct to the EUS transductor was also recorded (mm). T-student for quantitative variables was applied. Statistical significance was defined as p value ≤ 0.05.

Results

The mean surgical time was 29.5 ± 14.9 min. In five pigs (20%), some mild intraoperative problems occurred. A severe postoperative complication occurred in one animal (4%). No postoperative mortality was registered. Postoperative serum analyses showed an increase in total bilirubin (p = 0.005) and gamma glutamyl transferase levels (p = 0.001). Postoperative EUS showed dilatation of the intrahepatic bile duct in 76% of pigs, with a mean diameter of 9.6 ± 3.6 mm (distance from the gastric wall of 17.0 ± 6.4 mm).

Conclusion

The surgical procedure described here is a safe technique to induce dilatation of the intrahepatic bile ducts in the pig, with a minimally invasive approach and a high efficacy rate. This animal model might be useful for EUS techniques training and for evaluating new therapeutic approaches.

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Funding

No grant or financial support was given for this study.

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Authors and Affiliations

  1. General Surgery Department, University Hospital Arnau de Vilanova, Lleida, Spain

    Jaume Tur-Martínez, Pablo Muriel, Gian Pier Protti & Jorge Juan Olsina-Kissler

  2. Centre de Recerca Experimental Biomèdica Aplicada (CREBA), IRBLleida, Lleida, Spain

    Dolores C. García-Olmo, Sara Puy, Gian Pier Protti, Alba Boldó & Jorge Juan Olsina-Kissler

  3. Gastroenterology and Endoscopy Unit, Hospital Universitario Rio Hortega, Valladolid, Spain

    Mario A. Gallardo, Sergio Bazaga & Manuel Pérez-Miranda

  4. General Surgery Department, University Hospital Mútua Terrassa, Plaça Dr. Robert, 5, 08221, Terrassa, Barcelona, Spain

    Jaume Tur-Martínez

Authors
  1. Jaume Tur-Martínez
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  2. Dolores C. García-Olmo
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  3. Sara Puy
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  4. Pablo Muriel
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  5. Gian Pier Protti
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  6. Alba Boldó
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  9. Manuel Pérez-Miranda
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  10. Jorge Juan Olsina-Kissler
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Contributions

JT-M, DCG-O, and JJOK, designed the study. JT-M, PM, GPP, and MAG performed the surgical procedures. DCG-O, SP, and AB performed the anaesthetic procedures, pigs’ control, and registered all the data. MP-M and SB executed the endoscopic ultrasound procedures. JT-M and DCG-O analysed the data. All authors contributed in writing the manuscript. All authors carried out a critical review of the manuscript and approved the final version.

Corresponding author

Correspondence to Jaume Tur-Martínez.

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Disclosures

Dr. Jaume Tur-Martínez, Dr. Dolores C. García-Olmo, Mrs. Sara Puy, Dr. Pablo Muriel, Dr. Gian Pier Protti, Mrs. Alba Boldó, Dr. Mario A. Gallardo, Dr. Sergio Bazaga, Dr. Manuel Pérez-Miranda, and Dr. Jorge Juan Olsina-Kissler have no conflicts of interest or financial ties to disclose.

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Tur-Martínez, J., García-Olmo, D.C., Puy, S. et al. A new minimally invasive porcine model for the study of intrahepatic bile duct dilatation. Surg Endosc 35, 2817–2822 (2021). https://doi.org/10.1007/s00464-020-07716-z

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  • DOI: https://doi.org/10.1007/s00464-020-07716-z

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