Endoscopic endoclip papilloplasty preserves sphincter of oddi function.
endoscopic endoclip papilloplasty
endoscopic sphincterotomy
papillary healing
porcine model
sphincter of oddi dysfunction
Journal
European journal of clinical investigation
ISSN: 1365-2362
Titre abrégé: Eur J Clin Invest
Pays: England
ID NLM: 0245331
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
15
06
2020
revised:
06
08
2020
accepted:
04
09
2020
pubmed:
16
9
2020
medline:
30
11
2021
entrez:
15
9
2020
Statut:
ppublish
Résumé
Endoscopic sphincterotomy (EST) can destroy sphincter of Oddi (SO) structure and function. The purpose of this study was to assess the feasibility of endoscopic endoclip papilloplasty (EEPP) in restoring SO function after EST. Seven 26-week-old domestic pigs were divided into control and EEPP groups. Necropsy and haematoxylin-eosin staining plus anti-α-smooth muscle actin (α-SMA) staining of papilla and sphincter of Oddi manometry (SOM) were conducted in animals at three independent time points. EST and EEPP were safely performed in all 7 pigs without serious adverse events. For primary outcome, compared to the controls, EEPP generated smaller dilation and less inflammation. Fibrous repair of the papilla was observed at 24 weeks after EEPP. For secondary outcome, in the control group, SO basal pressure (17.25 ± 18.14 to 5.50 ± 0.71 mmHg), SO contraction amplitude (46.00 ± 19.20 to 34.50 ± 48.79 mmHg), peak (4.50 ± 4.04 to 1.50 ± 2.12) and frequency (3.05 ± 3.29 to 1.41 ± 2.19/min) were reduced after EST. Further reductions to almost 0 of these SOM parameters were observed 3 weeks later, including common bile duct pressure and SO contraction period. In contrast, in the EEPP group, these manometric data were recovered to pre-EST levels, including CBD pressure (11.5 ± 7.31 vs 11 ± 2.16 mmHg), SO pressure (17.50 ± 17.75 vs 18.20 ± 21.39 mmHg) and SO contraction amplitude (53.67 ± 21.54 vs 60.00 ± 36.08 mmHg). However, no significant differences were observed between control and EEPP groups by Student t test. In this porcine study, EEPP accelerated and improved papillary healing after EST, further preserved SO function.
Sections du résumé
BACKGROUND
BACKGROUND
Endoscopic sphincterotomy (EST) can destroy sphincter of Oddi (SO) structure and function. The purpose of this study was to assess the feasibility of endoscopic endoclip papilloplasty (EEPP) in restoring SO function after EST.
METHODS
METHODS
Seven 26-week-old domestic pigs were divided into control and EEPP groups. Necropsy and haematoxylin-eosin staining plus anti-α-smooth muscle actin (α-SMA) staining of papilla and sphincter of Oddi manometry (SOM) were conducted in animals at three independent time points.
RESULTS
RESULTS
EST and EEPP were safely performed in all 7 pigs without serious adverse events. For primary outcome, compared to the controls, EEPP generated smaller dilation and less inflammation. Fibrous repair of the papilla was observed at 24 weeks after EEPP. For secondary outcome, in the control group, SO basal pressure (17.25 ± 18.14 to 5.50 ± 0.71 mmHg), SO contraction amplitude (46.00 ± 19.20 to 34.50 ± 48.79 mmHg), peak (4.50 ± 4.04 to 1.50 ± 2.12) and frequency (3.05 ± 3.29 to 1.41 ± 2.19/min) were reduced after EST. Further reductions to almost 0 of these SOM parameters were observed 3 weeks later, including common bile duct pressure and SO contraction period. In contrast, in the EEPP group, these manometric data were recovered to pre-EST levels, including CBD pressure (11.5 ± 7.31 vs 11 ± 2.16 mmHg), SO pressure (17.50 ± 17.75 vs 18.20 ± 21.39 mmHg) and SO contraction amplitude (53.67 ± 21.54 vs 60.00 ± 36.08 mmHg). However, no significant differences were observed between control and EEPP groups by Student t test.
CONCLUSIONS
CONCLUSIONS
In this porcine study, EEPP accelerated and improved papillary healing after EST, further preserved SO function.
Substances chimiques
Actins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13408Subventions
Organisme : Capital Clinical Characteristic Application Research Project
ID : Z181100001718149
Organisme : National Natural Science Foundation of China
ID : 81470905
Informations de copyright
© 2020 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.
Références
Classen M, Demling L. Endoscopic sphincterotomy of the papilla of vater and extraction of stones from the choledochal duct (author's transl). Dtsch Med Wochenschr. 1974;99:496-497.
Kawai K, Akasaka Y, Murakami K, Tada M, Koli Y. Endoscopic sphincterotomy of the ampulla of Vater. Gastrointest Endosc. 1974;20:148-151.
Tanaka M, Takahata S, Konomi H, et al. Long-term consequence of endoscopic sphincterotomy for bile duct stones. Gastrointest Endosc. 1998;48:465-469.
Kageoka M, Watanabe F, Maruyama Y, et al. Long-term prognosis of patients after endoscopic sphincterotomy for choledocholithiasis. Dig Endosc. 2009;21:170-175.
Oliveira-Cunha M, Dennison AR, Garcea G. Late complications after endoscopic sphincterotomy. Surg Laparosc Endosc Percutan Tech. 2016;26:1-5.
Nzenza TC, Al-Habbal Y, Guerra GR, Manolas S, Yong T, McQuillan T. Recurrent common bile duct stones as a late complication of endoscopic sphincterotomy. BMC Gastroenterol. 2018;18:39.
Afghani E, Lo SK, Covington PS, Cash BD, Pandol SJ. Sphincter of Oddi function and risk factors for dysfunction. Front Nutr. 2017;4:1.
Yang J, Jin H, Gu W, Zhang X, Zhang X. Determinants of long-term complications of endoscopic sphincterotomy are infections and high risk factors of bile duct and not sphincter of Oddi dysfunction. Eur J Gastroenterol Hepatol. 2015;27:412-418.
Fan X, Li X, Chang H, Yan X, Huang Y. Endoclip papilloplasty for a patulous and incompetent biliary papilla. VideoGIE. 2019;4:331-333.
Kilkenny C, Browne WJ, Cuthi I, Emerson M, Altman DG. Improving bioscience research reporting: the ARRIVE guidelines for reporting animal research. Vet Clin Pathol. 2012;41:27-31.
Huang YH, Wang K, Zhang HJ, Chang H, Yan XE. A preliminary study of sphincter-preserving effect of SureClip from MicroTech on duodenal papilla occlusion. Chin J Dig Endosc. 2018;35:823-827.
Sato H, Kodama T, Takaaki J, et al. Endoscopic papillary balloon dilatation may preserve sphincter of Oddi function after common bile duct stone management: evaluation from the viewpoint of endoscopic manometry. Gut. 1997;41:541-544.
Rong ZH, Chen HY, Wang XX, et al. Effects of sphincter of Oddi motility on the formation of cholesterol gallstones. World J Gastroenterol. 2016;22:5540-5547.
Kuo YT, Wang HP, Chang CY, et al. Comparable long-term outcomes of 1-minute vs 5-minute endoscopic papillary balloon dilation for bile duct stones. Clin Gastroenterol Hepatol. 2017;15:1768-1775.
Yasuda I, Tomita E, Enya M, Kato T, Moriwaki H. Can endoscopic papillary balloon dilation really preserve sphincter of Oddi function? Gut. 2001;49:686-691.
Cheon YK, Lee TY, Kim SN, Shim CS. Impact of endoscopic papillary large-balloon dilation on sphincter of Oddi function: a prospective randomized study. Gastrointest Endosc. 2017;85:782-790.e1.
Park BK, Seo JH, Jeon HH, et al. A nationwide population-based study of common bile duct stone recurrence after endoscopic stone removal in Korea. J Gastroenterol. 2018;53:670-678.
Kaufman HS, Magnuson TH, Lillemoe KD, Frasca P, Pitt HA. The role of bacteria in gallbladder and common duct stone formation. Ann Surg. 1989;209:584-592.
Wietecha MS, DiPietro LA. Therapeutic approaches to the regulation of wound angiogenesis. Adv Wound Care (New Rochelle). 2013;2:81-86.
Higashiyama R, Nakao S, Shibusawa Y, et al. Differential contribution of dermal resident and bone marrow-derived cells to collagen production during wound healing and fibrogenesis in mice. J Invest Dermatol. 2011;131:529-536.
Darby IA, Laverdet B, Bonté F, Desmoulière A. Fibroblasts and myofibroblasts in wound healing. Clin Cosmet Investig Dermatol. 2014;7:301-311.
Guelrud M, Mendoza S, Rossiter G, Villegas MI. Sphincter of Oddi manometry in healthy volunteers. Dig Dis Sci. 1990;35:38-46.
Geenen JE, Toouli J, Hogan WJ, et al. Endoscopic sphincterotomy: follow-up evaluation of effects on the sphincter of Oddi. Gastroenterology. 1984;87:754-758.