Endoscopic gastrojejunostomy with survival in a porcine model

Sergey V. Kantsevoy, Sanjay B. Jagannath, Hideaki Niiyama, Sydney S.C. Chung, Peter B. Cotton, Christopher J. Gostout, Robert H. Hawes, Pankaj J. Pasricha, Carolyn A. Magee, Cheryl A. Vaughn, David Barlow, Hideki Shimonaka, Anthony N. Kalloo

Research output: Contribution to journalArticle

359 Scopus citations

Abstract

Background: We have previously reported the feasibility and the safety of an endoscopic transgastric approach to the peritoneal cavity in a porcine model. We now report successful performance of endoscopic gastrojejunostomy with survival. Methods: All procedures were performed on 50-kg pigs, with the pigs under general anesthesia, in aseptic conditions with sterilized endoscopes and accessories. The stomach was irrigated with antibiotic solution, and a gastric incision was performed with a needle-knife and a sphincterotome. A standard upper endoscope was advanced through a sterile overtube into the peritoneal cavity. A loop of jejunum was identified, was retracted into the stomach, and was secured with sutures while using a prototype endoscopic suturing device. An incision was made into the jejunal loop with a needle-knife, and the filet-opened ends of the jejunal wall were secured to the gastric wall with a second line of sutures, completing the gastrojejunostomy. Observations: Two pigs survived for 2 weeks. Endoscopy and a radiographic contrast study performed after gastrojejunostomy revealed a patent anastomosis with normal-appearing gastric and jejunal mucosa. Postmortem examination demonstrated a well-healed anastomosis without infection or adhesions. Conclusions: The endoscopic transgastric approach to create a gastrojejunostomy is technically feasible and can be performed, with survival, in a porcine model.

Original languageEnglish (US)
Pages (from-to)287-292
Number of pages6
JournalGastrointestinal endoscopy
Volume62
Issue number2
DOIs
StatePublished - Aug 1 2005

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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    Kantsevoy, S. V., Jagannath, S. B., Niiyama, H., Chung, S. S. C., Cotton, P. B., Gostout, C. J., Hawes, R. H., Pasricha, P. J., Magee, C. A., Vaughn, C. A., Barlow, D., Shimonaka, H., & Kalloo, A. N. (2005). Endoscopic gastrojejunostomy with survival in a porcine model. Gastrointestinal endoscopy, 62(2), 287-292. https://doi.org/10.1016/S0016-5107(05)01565-8