Park Jin-Seok, Jeong Seok, Kwon Chang-Il, Jong Choi Hyun, Hee Koh Dong, Hee Cho Jae, Jin Hyun Jong, Moon Jong-Ho, Lee Don Haeng
Digestive Disease Center, Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea.
The National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders (NCEED), Incheon, South Korea.
Dig Endosc. 2016 Jul;28(5):592-8. doi: 10.1111/den.12624. Epub 2016 Apr 5.
A reproducible in vivo swine model of bile duct dilation (BDD) was recently established and reported for preclinical testing of newly developed biliary devices or endoscopic techniques. The aim of the present study was to develop a more advanced large animal model in which it is possible to direct examination of the biliary tree. Methods Six mini pigs were prepared for the study. BDD models were first made by closure of the Vater's ampulla in all swine. Then endoscopic papillary balloon dilation (EPBD) was done in the animals. Feasibility of single-operator peroral cholangioscopy without assistance of accessories was evaluated using an ultra-slim upper endoscope in the animals. Results EPBD could be implemented using a dilation balloon catheter (10~13.5 mm) in all BDD models (6/6, 100%). Success rate of freehand direct insertion of an ultra-slim endoscope into the common bile duct was 100% (6/6), and access to the common hepatic duct with examination was possible using direct peroral cholangioscopy in five animals (5/6, 83.3%). None of the animals died. In the cholangioscopic examination, a bile duct polyp and a benign biliary stricture occurred naturally, respectively, in two of the six swine. Conclusion An in vivo swine model of biliary dilatation-based direct peroral cholangioscopy was established. This novel animal model may be useful for preclinical research of new materials or devices because direct visualization of the biliary tree is feasible.
最近建立并报道了一种可重复的胆管扩张（BDD）体内猪模型，用于新开发的胆道装置或内镜技术的临床前测试。本研究的目的是开发一种更先进的大型动物模型，以便能够直接检查胆管树。方法 为该研究准备了6只小型猪。首先通过封闭所有猪的十二指肠乳头制作BDD模型。然后对动物进行内镜乳头球囊扩张（EPBD）。使用超薄上消化道内镜在动物中评估在无辅助配件的情况下单人经口胆管镜检查的可行性。结果 在所有BDD模型（6/6，100%）中均可使用扩张球囊导管（10~13.5 mm）实施EPBD。徒手将超薄内镜直接插入胆总管的成功率为100%（6/6），5只动物（5/6，83.3%）可通过经口直接胆管镜检查进入肝总管并进行检查。没有动物死亡。在胆管镜检查中，6只猪中的2只分别自然出现了胆管息肉和良性胆管狭窄。结论 建立了基于胆管扩张的体内猪经口直接胆管镜检查模型。这种新型动物模型可能对新材料或装置的临床前研究有用，因为直接观察胆管树是可行的。
