Abstract
Introduction: Gastrojejunal anastomosis is commonly performed for malignant gastric outlet obstruction. This study aimed to investigate feasibility and safety of a novel approach in performing transgastric endoluminal gastrojejunostomy using endostapling technique. MethodUnder general anesthesia, endoscope is passed through gastrotomy in porcine model and retrieve a segment of small bowel into the stomach. An enterotomy is created, and an EndoGIA stapler is introduced through an intragastric port and pass between small bowel and stomach wall. A gastrojejunostomy is formed after firing of the EndoGIA stapler. The pigs are allowed to resume on diet one day after the operation and survive for two weeks prior to euthanasia. The patency of the gastrojejunostomy will be confirmed. Results12 TEGJ were performed, 10 of which were successful. The mean operative time was 53.6 ± 45.7 mins. One TEGJ was converted to open due to mispositioning of intragastric port, while the other failed because the enterotomy was too extensive. All 10 pigs survived for 2 weeks, and endoscopic examination with contrast study confirmed all the GJ were patent. On post-mortem examination, the average size of GJ was 30mm. Conclusion: Transgastric endoscopic gastrojejunostomy is technically feasible with a patent and sizable anastomosis. View Large Image Figure Viewer Download Hi-res image
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