超声内镜引导下经胃单向胆囊引流及闭合后胆囊病理生理的功能研究

胆囊炎系临床常见病，人口老龄化使高龄重症患者增加，给临床诊治带来了巨大挑战。超声内镜（EUS）引导下胆囊引流是近年来出现的治疗胆囊炎的微创新技术，尤其适用于一般条件差、不宜行外科手术的高龄患者。课题组前期研究发现EUS引导下经胃胆囊引流对消化道解剖结构和后期桥接胆囊切除术影响小，但胃内食物易污染胆囊，会改变局部微生态及菌群多样性，增加胆囊炎复发率；经十二指肠引流则可减少污染，适于长期留置，但增加后期桥接胆囊切除手术难度。为此，课题组研发了单向经胃引流支架，既能有效解决食物污染胆囊，又能降低后期手术难度。本项目拟通过动物实验，在明确经胃单向胆囊引流的有效性和安全性的前提下，深入研究引流通道的液体流向变化对术后胆囊及胆道微环境内细菌种属改变、胆囊功能和对周边组织的解剖影响，为该技术的临床推广提供应用基础，有望为高龄危重胆囊炎患者提供安全、高效、微创的治疗手段，对危重胆囊炎微创治疗策略产生影响。

Cholecystitis, a common disease,is bringing great challenges to clinical diagnosis and treatment, as the aging of the population causes an increasing number of elderly patients with severe disease increases. Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is a micro-innovative technology emerging and developing rapidly in recent years, which is especially suitable for elderly patients with severe general conditions and unsuitable for surgery. Early research by our team found that EUS-guided gastric-gallbladder drainage had slight effect on digestive tract anatomy and later bridged cholecystectomy, but food in the stomach was likely to contaminate the gallbladder, which would change the local microecology and bacterial diversity and increase the recurrence risk of cholecystitis. ; Drainage through the duodenum can reduce pollution and is suitable for long-term indwelling, but increases the difficulty of late bridge cholecystectomy. To this end, our team developed an one-way transgastric drainage stent, which can effectively solve the food contamination of the gallbladder and reduce the difficulty of later surgery. This project intends to use animal experiments to deeply study the effectiveness and safety of one-way transgastric gallbladder drainage , and to further study the changes in the fluid flow direction of the drainage channel on the postoperative gallbladder and biliary microenvironment bacterial species changes, gallbladder function and the anatomical impact on the surrounding tissues,which will provide a basis for the clinical promotion of this technology. It is expected to provide safe, efficient, and minimally invasive treatment methods for elderly patients with critical cholecystitis and to have an impact on the minimally invasive treatment strategies for critical cholecystitis.