Development of a swine bile duct dilation model using endoclips or a detachable snare under cap-assisted endoscopy.
BACKGROUND
A reproducible large animal model of bile duct dilation for the preclinical testing of new biliary devices and for training endoscopic biliary intervention is required. Surgical methods are mainly used to produce large animal models of biliary obstruction.


OBJECTIVE
To develop an animal model of bile duct dilation using endoscopic methods and to compare the merits of endoclips and detachable snares for the obstruction of major duodenal papillae.


METHODS
Proof of concept experimental study.


METHODS
Animal laboratory.


METHODS
Endoscopic clipping of the major duodenal papilla or closure of the major duodenal papilla with a detachable snare.


METHODS
Feasibility, efficacy, and safety of endoscopic methods to develop swine models with bile duct dilation were estimated by degree of dilation at the common bile duct (CBD), intrahepatic duct (IHD), and gallbladder (GB).


RESULTS
All animals survived until the end of the experiment. Clipping of the major duodenal papilla and closure of the major duodenal papilla with a detachable snare were performed successfully in all swine. No technical difficulty or adverse event occurred during the procedures. Biliary dilatations in all animals were observed on cholangiograms (mean Δ% of postprocedural and preprocedural maximum diameters: CBD, 301%; IHD, 223.5%; GB, 34.8%). Degree of bile duct dilation in the snare group tended to be greater (CBD, 367.3%; IHD, 298.3%; GB, 47.8%) than in the endoclip group (CBD, 234.7%; IHD, 148.7%; GB, 21.8%), but this difference was not significant. An analysis of degrees of dilation according to location in the biliary tree showed that the GB was not dilated as well as the CBD or IHD.


CONCLUSIONS
Animal model.


CONCLUSIONS
The 2 endoscopic procedures described are effective and safe for creating a swine model of bile duct dilation and could be helpful for training biliary intervention and for endoscopic biliary studies.
Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
Jin-Seok
JS
Park
Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Chang-Il
CI
Kwon
Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea; National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Incheon, Korea.
Seok
S
Jeong
Department of Pathology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Kwangil
K
Kim
Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Korea.
Jong Ho
JH
Moon
Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea; National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Incheon, Korea; Utah-Inha DDS & Advanced Therapeutics Research Center, Incheon, Korea.
Don Haeng
DH
Lee
D014670:Ampulla of Vater; D000818:Animals; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D003135:Common Bile Duct / Q000473:pathology*; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D004195:Disease Models, Animal; D016145:Endoscopy, Digestive System / Q000295:instrumentation*; D005704:Gallbladder / Q000473:pathology*; D011859:Radiography; D013525:Surgical Instruments; D013552:Swine