Evaluation of compression cholecystogastric and cholecystojejunal anastomoses in swine after peroral and surgical introduction of magnets.

PURPOSE

To assess the efficacy of rare-earth magnets for creating a cholecystogastrostomy (CG) or cholecystojejunostomy (CJ) in nine swine.

MATERIALS AND METHODS

Neodymium-iron-boron magnets or rare-earth cobalt magnets of various configuration and strength were coupled in pairs to form four CGs and five CJs. Magnets were implanted surgically in the gallbladder and jejunum, and perorally in the stomach. Gross and histologic examinations of anastomoses were performed 8-16 days later.

RESULTS

All anastomoses showed good adhesion with no leakage and minimal inflammation. Anastomoses were fully patent in four CJs and one CG (mean, 12 days), partially patent in one CJ and one CG (mean, 15 days), and not patent in two CGs. Best results were noted with jacketed disc magnets with cutting rims and a 400-600-g pull. The rare-earth magnets were significantly weakened by gas sterilization in the first four CG experiments. Two of four magnets used in CJ were retained despite a fully patent anastomosis.

CONCLUSION

Leak-free patent or partially patent cholecystenteric anastomoses were created by magnet compression in 9-16 days. This technique may have clinical interventional applications.