Department of Endoscopy, Eastern Hepatobiliary Hospital, The Second Military Medical University, Shanghai, China.
Surg Laparosc Endosc Percutan Tech. 2020 Dec;30(6):e52-e58. doi: 10.1097/SLE.0000000000000872.
A reliable large animal model of benign biliary stricture (BBS) is essential to study endoscopic management of BBS. The aim of this study was to establish a swine BBS model of endobiliary electrothermal injury with a diathermic sheath and screen out the optimal energy dose.
Twelve swine were equally randomized into a low (20 W), a medium (30 W), and a high (40 W)-dose group. Endobiliary electrothermal injury was applied to the common bile duct using a diathermic sheath at different energy doses for 20 seconds via endoscopic retrograde cholangiopancreatography. Cholangiographic findings and liver function were evaluated weekly after thermal injury. Two animals from each group were sacrificed at 2 weeks and the other 2 sacrificed 4 weeks after thermal injury for histopathologic evaluation.
BBS was established successfully in 10 of the 12 animals. Two of the 4 animals in low-dose group did not produce biliary stricture at 4 weeks; in medium-dose group, BBS was induced in both animals at 2 weeks without causing severe complications; and in high-dose group, BBS was produced in 4 animals at 2 weeks, causing perforation and abdominal abscess formation in 1 animal.
A safe and reproducible swine model of BBS could be established successfully by applying endobiliary electrothermal injury with a diathermic sheath at 30 W for 20 seconds.
建立可靠的大型动物良性胆管狭窄（BBS）模型对于研究 BBS 的内镜治疗至关重要。本研究旨在建立一种使用热传导鞘的胆道内电热损伤猪 BBS 模型，并筛选出最佳能量剂量。
将 12 头猪等分为低（20W）、中（30W）、高（40W）剂量组。通过内镜逆行胰胆管造影术，使用热传导鞘在不同能量剂量下对胆总管进行 20 秒的胆道内电热损伤。热损伤后每周进行胆管造影检查和肝功能评估。每组各有 2 只动物在 2 周时处死，其余 2 只在 4 周时处死，进行组织病理学评估。
12 只动物中有 10 只成功建立了 BBS。低剂量组的 4 只动物中有 2 只在 4 周时未发生胆管狭窄；中剂量组的 2 只动物在 2 周时均发生了 BBS，但未引起严重并发症；高剂量组的 4 只动物在 2 周时均发生了 BBS，其中 1 只发生了穿孔和腹腔脓肿形成。
通过使用热传导鞘在 30W 下进行 20 秒的胆道内电热损伤，可以成功建立一种安全且可重复的猪 BBS 模型。
