Abstract
BACKGROUND AND AIMS: EUS-guided gallbladder drainage (EUS-GBD) using a lumen-apposing metal stent (LAMS), originally developed as drainage for cholecystitis, enables endoscopic access into the gallbladder lumen. However, few studies have investigated the feasibility of peroral cholecystoscopy (POCCS)-guided interventions through a LAMS. METHODS: EUS-GBD using a LAMS followed by POCCS-guided interventions were performed in 4 swine. Technical success, safety, and feasibility of POCCS visualization and POCCS-guided biopsy sampling and mucosal resection through the LAMS immediately and 3 weeks after EUS-GBD were investigated. Additionally, all specimens including necropsy were pathologically evaluated. RESULTS: POCCS and target biopsy sampling were successful through the LAMS in all swine immediately after EUS-GBD, without any adverse events. POCCS-guided biopsy sampling and mucosal resection 3 weeks after EUS-GBD were technically feasible and pathologically assessable in all swine. The necropsy specimens displayed hyperplastic and inflammatory changes in the gallbladder and nearby organs after 3 weeks of EUS-GBD. CONCLUSIONS: POCCS-guided interventions including mucosal resection were technically feasible through a LAMS after EUS-GBD.