Creation of an effective and reproducible nonsurvival porcine model that simulates actively bleeding peptic ulcers

Background

Efforts to develop improved endoscopic therapeutic methods for upper GI bleeding require an effective animal model.

Objective

To develop a nonsurvival porcine model that simulates acute peptic ulcer bleeding.

Design

Prospective animal (porcine) study.

Setting

Animal laboratory.

Interventions

A surgical seromyotomy was created along the external surface of the greater curvature of the stomach in anesthesized pigs. A submucosal plane was developed and the gastroepiploic bundle, in continuity, was placed adjacent to the mucosa, and the seromuscular tissues were re-approximated over the vascular bundle. By using EGD, a needle-knife with electrocautery was then used to incise the mucosal tissue overlying the vascular bundle. Standard endoscopic methods for bleeding control were then tested in this animal model.

Main Outcome Measurements

To evaluate whether successful bleeding that simulates submucosal arterial bleeding from peptic ulcer disease could be achieved in a porcine animal model.

Results

Successful simulation of active peptic ulcer bleeding was achieved with this nonsurvival porcine model in a total of 5 sequential pigs. Other porcine models for bleeding were tested and found to be unsatisfactory. Hemoclips and combination injection-thermal therapy were used to stop bleeding over Doppler-positive areas, with subsequent endoscopic nonimaging Doppler US probe examination of the ulcer bed revealing a negative Doppler signal.

Limitations

This was an animal laboratory study. Further human studies would be ideal once any future endoscopic interventions are proven to be safe in animals.

Conclusions

This active bleeding ulcer model can be used to develop future endoscopic therapies and for training purposes.

Abbreviations: U, unit, UGIB, upper gastrointestinal bleeding