Abstract
Background and study aims EUS-guided gastroenterostomy (GE) is a novel, minimally invasive endoscopic procedure
for the treatment of gastric outlet obstruction (GOO). The direct-EUS-GE (D-GE) approach
has recently gained traction. We aimed to report on a large cohort of patients who
underwent DGE with focus on long-term outcomes.
Patients and methods This two-center, retrospective study involved consecutive patients who underwent
D-GE between October 2014 and May 2018. The primary outcomes were technical and clinical
success. Secondary outcomes were adverse events (AEs), rate of reintervention, procedure
time, time to resume oral diet, and post-procedure length of stay (LOS).
Results A total of 57 patients (50.9 % female; median age 65 years) underwent D-GE for GOO.
The etiology was malignant in 84.2 % and benign in 15.8 %. Technical success and clinical
success were achieved in 93 % and 89.5 % of patients, respectively, with a median
follow-up of 196 days in malignant GOO and 319.5 days in benign GOO. There were 2
(3.5 %) AEs, one severe and one moderate. Median procedure time was 39 minutes (IQR,
26 – 51.5 minutes). Median time to resume oral diet after D-GE was 1 day (IQR 1 – 2
days). Median post D-GE LOS was 3 days (IQR 2 – 7 days). Rate of reintervention was
15.1 %.
Conclusions D-GE is safe and effective in management of both malignant and benign causes of GOO.
Clinical success with D-GE is durable with a low rate of reintervention based on a
long-term cohort.
