Endoscopic endoclip papilloplasty preserves sphincter of oddi function

Abstract

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 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 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 In this porcine study, EEPP accelerated and improved papillary healing after EST, further preserved SO function.

Laparoscopic ileocecal-sparing vs traditional right hemicolectomy for cancer of the hepatic flexure or proximal transverse colon: a dual-center propensity score-matched study

“…Therefore, organ-preserving and function-preserving surgical techniques are quickly emerging. Examples include pylorus-preserving radical gastrectomy [ 19 ], duodenum-preserving pancreatectomy [ 20 ], and duodenal papillary sphincteroplasty with preservation of the sphincter of Oddi [ 21 ]. We utilized laparoscopic techniques for skeletonizing the ICA, and blood perfusion for ileocecal-colic anastomosis was secured by selective vessel preservation.…”

LncRNAs‐circRNAs as Rising Epigenetic Binary Superstars in Regulating Lipid Metabolic Reprogramming of Cancers

“…[138] Additionally, circ_0 0 08078 can inhibit the tube formation ability of esophagus cancer via interfering the ELOVL4mediated lipid metabolism. [118] Lymphangiogenesis, like angiogenesis, involves the formation of new vessels, but in this case, it is new lymphatic vessels forming from pre-existing ones. This process is considered an important step in lymph node metastasis in cancer.…”

“…For the elongation of de novo fatty acids, circ_0 0 08078 was identified to be downregulated in esophagus cancer (EC), which promoted ELOVL4 expression via miR‐191‐5p, and regulated the proliferation, tube formation, migration and invasion of EC. [ 118 ] For the desaturation of de novo fatty acids, these lipid‐metabolic related lncRNAs and circRNAs can involve the SCD‐mediated desaturation of de novo fatty acids. For instance, a novel linc00174 has been identified to modulate the SCD5‐meditated lipid production by absorbing miR‐145‐5p in thymic epithelial tumors (TETs).…”

“…[ 138 ] Additionally, circ_0 0 08078 can inhibit the tube formation ability of esophagus cancer via interfering the ELOVL4‐mediated lipid metabolism. [ 118 ]…”

Hotspots and difficulties of biliary surgery in older patients

“…Zeng and Dong [ 32 ] suggested that patients with iatrogenic injury of the sphincter of Oddi should be treated with transduodenal sphincteroplasty to restore the structural integrity of the sphincter and reduce biliopancreatic duct complications secondary to loss of function. Recently, Wang et al [ 33 ] reported that endoscopic endoclip papilloplasty (EEPP) had accelerated and improved the papillary healing after EST and preserved the physiological function of the sphincter of Oddi. The importance of this report is that EEPP may be a safe and potentially beneficial procedure in reducing post-EST complications.…”