Image-Guided Surgical Training in Percutaneous Hepatobiliary Procedures: Development of a Realistic and Meaningful Bile Duct Dilatation Porcine Model.

Fiche publication

Date publication

septembre 2020

Journal

Journal of laparoendoscopic & advanced surgical techniques. Part A

Auteurs

Membres identifiés du Cancéropôle Est :
Pr MARESCAUX Jacques

Tous les auteurs :
Giménez ME, Garcia Vazquez A, Davrieux CF, Verde JM, Serra E, Palermo M, Houghton EJ, Dallemagne B, Perretta S, Acquafresca PA, Diana M, Marescaux J

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/32991240

Résumé

Malignant or benign biliary obstructions can be successfully managed with minimally invasive percutaneous interventions. Since percutaneous approaches are challenging, extensive training using relevant models is fundamental to improve the proficiency of percutaneous physicians. The aim of this experimental study was to develop an training model in pigs to simulate bile duct dilatation to be used during percutaneous biliary interventions. Twenty-eight large white pigs were involved and procedures were performed in an experimental hybrid operating room. Under general anesthesia, animals underwent a preoperative magnetic resonance cholangiography (MRC). Afterward, the common bile duct was isolated and ligated laparoscopically. A postoperative MRC was performed 72 hours after the procedure to evaluate bile duct dilatation. The models presenting an effective dilatation model were included in the hands-on part of a percutaneous surgery training course. Animals were euthanized at the end of the training session. Postoperative MRC confirmed the presence of bile duct dilatation in the survival pigs ( = 25). No intraoperative complications occurred and mean operative time was 15.8 ± 5.27 minutes. During the course, 27 trainees could effectively perform percutaneous transhepatic cholangiography, bile duct drainage, biliary duct dilatation, and stent placement, with > 90% success rate, thereby validating the experimental model. All animals survived during the training procedures and complications occurred in 28.3% of cases. The creation of an bile duct dilatation animal model is feasible with a low short-term mortality. It provides a realistic and meaningful training model in percutaneous biliary procedures.