Percutaneous transcholecystic biliary interventions using gallbladder anchors: Feasibility study in the swine

Lopera, Jorge E., Kirsch, David, Qian, Zhong, Ruiz, Bernardo, Brazzini, Augusto, Gonzales, Arturo and Castaneda-Zuniga, Wifrido (2005) Percutaneous transcholecystic biliary interventions using gallbladder anchors: Feasibility study in the swine. Cardiovascular and Interventional Radiology, 28 4: 467-471. doi:10.1007/s00270-004-9215-4


Author Lopera, Jorge E.
Kirsch, David
Qian, Zhong
Ruiz, Bernardo
Brazzini, Augusto
Gonzales, Arturo
Castaneda-Zuniga, Wifrido
Title Percutaneous transcholecystic biliary interventions using gallbladder anchors: Feasibility study in the swine
Journal name Cardiovascular and Interventional Radiology   Check publisher's open access policy
ISSN 0174-1551
1432-086X
Publication date 2005-07
Sub-type Article (original research)
DOI 10.1007/s00270-004-9215-4
Volume 28
Issue 4
Start page 467
End page 471
Total pages 5
Place of publication New York, NY, United States
Publisher Springer
Language eng
Formatted abstract
The purpose of this study was to report our initial experience with a swine model for biliary interventions by using a percutaneous transcholecystic access after suture anchor of the gallbladder. Telepaque tablets were given to five pigs to opacify the gallbladder. Under fluoroscopy, the opacified gallbladder was punctured percutaneously and three suture anchors were used to fix the anterior wall of the gallbladder to the abdominal wall. Two weeks later, the gallbladder was punctured and access into the distal common bile was obtained through the cystic duct. Balloon expandable stents were deployed into the distal common bile duct. Follow-up cholangiograms were obtained at 1 and 2 weeks. Necropsy was performed after 2 weeks to evaluate the relationship between the gallbladder and abdominal wall. Suture anchor placement was successful in all five pigs. One pig with a deep and highly positioned gallbladder developed fever, anorexia, and vomiting secondary to excessive stretch of the gallbladder. Placement of the guidewire through the extremely tortuous and small cystic ducts proved to be the most challenging step of the procedure. Metallic stents were successfully deployed in all four pigs in which it was attempted. Four animals tolerated the procedures without changes in their clinical conditions and no symptoms. Successful follow-up cholangiograms were performed at 1 and 2 weeks post-stent deployment without complications. All stents remained patent during the follow-up period. Necropsy demonstrated close attachment and adherence of the gallbladders to the antero-lateral abdominal wall in all four animals. Suture anchoring of the gallbladder is feasible in most pigs with superficially located gallbladders. This technique allows a safe and repeat access into the biliary system using a transcholecystic approach.
Keyword Biliary interventions
Cholecystostomy
Animal-Model
Bile-Duct
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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