Abstract

cavity, which was followed by deployment of a lumen-apposing metal stent under fluoroscopic guidance. Next, the first portion of the duodenum was resected by an endoscopic linear stapler via laparoscopy, thereby creating the GOO model. Oral feeding was resumed 24 h after the procedure, and animals were euthanized at 1, 2, and 4 weeks after the operation. Results: Side-to-side gastrojejunostomy was successfully completed endoscopically in 10/11 animals. One case failed due to jejunal perforation during jejunotomy. The mean gastrojejunostomy procedure time was 41 min (range 15-94 min). No pigs died before the planned sacrifice date. At the end of 4 weeks, two pigs showed significant weight gain with a maximum increase of 101% from their initial body weight. Histological examination revealed adequate submucosal apposition without evidence of necrotic changes in all 10 experimental pigs. Conclusion: Creating a gastrojejunostomy endoscopically using a lumen-apposing metal stent seems to be a safe, feasible, durable, and reproducible method.

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