Endoscopic intraluminal closure of colon perforation with metal clip： a study in porcine model

Abstract

Objective To evaluate the feasibility and safety of endoscopic intraluminal closure of small colon perforation with metal clips in porcine model. Methods A 2 cm full-thickness colon perforation was made in 4 bama mini-pigs. One did not receive local closure as a control, while 3 others underwent closure with bi- and tri-arm clips, one of which received additional fibrin glue injection after closure. Necropsy was done on day 14 after the procedure, and dye leak test, peritoneal fluid bacteria culture and histologieal examination were performed. During the 2 week observation period, the body temperature and blood leukocytes count were recorded and compared. Results Endoscopic closure of the colon perforation was technically successful in all 3 pigs. The body temperature and blood leukocyte count of these pigs were both lower than those of the control. Necropsy showed that the perforation in control pig was not completely closed and with multiple adhesions around. Perforation complete closure and pathological healing without adhesion were observed in 2 pigs with clip closure only, while adhesion and incomplete pathological healing was detected in the other one with clip closure plus fibrinogen injection （P 〈 0. 05）. Conclusion Endoscopic intraluminal closure of a 2 cm colon perforation with metal clips is feasible and safe, while further study is needed to evaluate the effect of combined local fibrinogen injection. Key words: Intestinal perforation ; Pigs ; Endoluminal closure; Metal clips