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Miyagi et al: Endoscopic‐assisted laser sphincterotomy of the intramural common bile duct: A cadaveric pilot study
Veterinary Surgery 5, 2025

🔍 Key Findings

  • Endoscopic-assisted retrograde catheterization (EARC) and laser sphincterotomy were successful in 18/18 cadavers, demonstrating technical feasibility.
  • Intramural common bile duct (ICBD) length ranged from 10 to 21 mm (mean 15.8 mm), with no correlation to body weight (r = 0.06, p = .79).
  • Transition from ICBD to extramural duct was accurately identified endoscopically in 88% (16/18); transition was heralded by separation of the submucosal layer.
  • Partial lateral perforations occurred in 2/18 dogs, only during early learning phase; no leakage was found on open dissection.
  • Laser sphincterotomy preserved the pancreatic duct orifice, aided by protective catheter positioning.
  • Compared to open duodenotomy, this technique allows for a smaller incision and less manipulation of the pancreas, which may reduce morbidity.
  • No adverse events such as intra-abdominal saline egress or full-thickness perforation occurred, and the technique allowed safe access up to 10 mm from the MDP.
  • Cadaveric limitations included absence of biliary pathology and inability to evaluate live complications, but the technique shows promise for future live animal trials.

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← Articles

Miyagi et al: Endoscopic‐assisted laser sphincterotomy of the intramural common bile duct: A cadaveric pilot study
Veterinary Surgery 5, 2025

🔍 Key Findings

  • Endoscopic-assisted retrograde catheterization (EARC) and laser sphincterotomy were successful in 18/18 cadavers, demonstrating technical feasibility.
  • Intramural common bile duct (ICBD) length ranged from 10 to 21 mm (mean 15.8 mm), with no correlation to body weight (r = 0.06, p = .79).
  • Transition from ICBD to extramural duct was accurately identified endoscopically in 88% (16/18); transition was heralded by separation of the submucosal layer.
  • Partial lateral perforations occurred in 2/18 dogs, only during early learning phase; no leakage was found on open dissection.
  • Laser sphincterotomy preserved the pancreatic duct orifice, aided by protective catheter positioning.
  • Compared to open duodenotomy, this technique allows for a smaller incision and less manipulation of the pancreas, which may reduce morbidity.
  • No adverse events such as intra-abdominal saline egress or full-thickness perforation occurred, and the technique allowed safe access up to 10 mm from the MDP.
  • Cadaveric limitations included absence of biliary pathology and inability to evaluate live complications, but the technique shows promise for future live animal trials.

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Multiple Choice Questions on this study

In Miyagi 2025 et al., on endoscopic laser sphincterotomy, which feature helped protect the pancreatic duct during lasering?

A. Direct visual guidance
B. External abdominal compression
C. Lateral duodenal traction
D. Catheter positioned over pancreatic duct
E. Cooling irrigation during ablation

Answer: Catheter positioned over pancreatic duct

Explanation: The catheter served as a protective shield over the ductal orifice during the laser procedure.
In Miyagi 2025 et al., on endoscopic laser sphincterotomy, what was concluded regarding ICBD length and body weight?

A. Significant positive correlation observed
B. Length increased linearly with body weight
C. Larger dogs had longer ICBDs
D. No correlation was found
E. ICBD was shorter in heavier dogs

Answer: No correlation was found

Explanation: Statistical analysis showed no significant correlation (r = 0.06, p = .79).
In Miyagi 2025 et al., on endoscopic laser sphincterotomy, what was the outcome of the two cases with lateral perforation?

A. Intra-abdominal leakage occurred during irrigation
B. Perforations required open repair
C. No saline egress or visible damage was detected
D. Perforations led to full-thickness bile duct tears
E. Perforations resulted in death of cadavers

Answer: No saline egress or visible damage was detected

Explanation: The two perforations were not visible on post-dissection leak testing and did not cause saline escape.
In Miyagi 2025 et al., on endoscopic laser sphincterotomy, what was the mean length of the intramural common bile duct (ICBD) identified in dogs?

A. 5.8 ± 2.0 mm
B. 10.2 ± 3.5 mm
C. 15.8 ± 3.0 mm
D. 18.6 ± 4.2 mm
E. 20.1 ± 2.9 mm

Answer: 15.8 ± 3.0 mm

Explanation: ICBD length ranged from 10 to 21 mm, with a mean of 15.8 mm.
In Miyagi 2025 et al., on endoscopic laser sphincterotomy, what defined the transition between the intramural and extramural common bile duct (CBD)?

A. Entry into the peritoneal cavity
B. Bile backflow during lasering
C. Visualization of the pancreatic duct
D. Separation of the duodenal submucosa from CBD wall
E. Sudden increase in duct diameter

Answer: Separation of the duodenal submucosa from CBD wall

Explanation: This anatomic separation reliably marked the end of the ICBD and was used to prevent over-ablation.

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