Endoscopy 2021; 53(12): 1246-1249
DOI: 10.1055/a-1392-0904
Innovations and brief communications

Endoscopic ultrasound-guided gastroenterostomy using an oroenteric catheter-assisted technique: a retrospective analysis

1   Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California, United States
2   Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, South Australia
,
Christopher M. Hamerski
1   Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California, United States
,
Andrew Nett
1   Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California, United States
,
Rabindra R. Watson
1   Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California, United States
,
Morgan Rigopoulos
1   Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California, United States
,
Kenneth F. Binmoeller
1   Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California, United States
› Institutsangaben

Abstract

Background This study evaluated an oroenteric catheter (OEC)-assisted technique to distend the enteric loop for endoscopic ultrasound-guided gastroenterostomy (EUS-GE) in patients with gastric outlet obstruction (GOO).

Methods Patient outcomes were reviewed. Proximal enteric loops were filled with water via an OEC (7 Fr or 8 Fr), providing a target for EUS-GE using a lumen-apposing metal stent (15-mm caliber). Clinical success was defined as toleration of a non-liquid diet by Day 3.

Results 42 patients (mean age 73.1 [SEM 2.8] years; 23 male) underwent EUS-GE for malignant (n = 37) and benign (n = 5) duodenal strictures. EUS-GE creation was successful in 41/42 (98 %), with mean procedure time of 36 (SEM 3) minutes and no serious complications. Clinical success was achieved in 39/42 (93 %) at 5.7 (SEM 2.6) months’ follow-up. Of 14 patients who died, 13 (93 %) maintained oral intake until death. EUS-GE provided good symptom relief in all 28 surviving patients until follow-up.

Conclusions OEC-assisted EUS-GE provided satisfactory relief of GOO symptoms, with high technical success (98 %) and no serious complications.



Publikationsverlauf

Eingereicht: 05. August 2020

Angenommen nach Revision: 11. Januar 2021

Artikel online veröffentlicht:
15. April 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Uemura S, Iwashita T, Iwata K. et al. Endoscopic duodenal stent versus surgical gastrojejunostomy for gastric outlet obstruction in patients with advanced pancreatic cancer. Pancreatology 2018; 18: 601-607
  • 2 Rudolph HU, Post S, Schluter M. et al. Malignant gastroduodenal obstruction: retrospective comparison of endoscopic and surgical palliative therapy. Scand J Gastroenterol 2011; 46: 583-590
  • 3 Wong YT, Brams DM, Munson L. et al. Gastric outlet obstruction secondary to pancreatic cancer: surgical vs endoscopic palliation. Surg Endosc 2002; 16: 310-312
  • 4 Sasaki T, Isayama H, Nakai Y. et al. Clinical outcomes of secondary gastroduodenal self-expandable metallic stent placement by stent-in-stent technique for malignant gastric outlet obstruction. Dig Endosc 2015; 27: 37-43
  • 5 Park JH, Song HY, Yun SC. et al. Gastroduodenal stent placement versus surgical gastrojejunostomy for the palliation of gastric outlet obstructions in patients with unresectable gastric cancer: a propensity score-matched analysis. Eur Radiol 2016; 26: 2436-2445
  • 6 Binmoeller KF, Shah JN. Endoscopic ultrasound-guided gastroenterostomy using novel tools designed for transluminal therapy: a porcine study. Endoscopy 2012; 44: 499-503
  • 7 Perez-Miranda M, Tyberg A, Poletto D. et al. EUS-guided gastrojejunostomy versus laparoscopic gastrojejunostomy: an international collaborative study. J Clin Gastroenterol 2017; 51: 896-899
  • 8 Khashab MA, Kumbhari V, Grimm IS. et al. EUS-guided gastroenterostomy: the first US. clinical experience (with video). Gastrointest Endosc 2015; 82: 932-938
  • 9 Chen YI, Itoi T, Baron TH. et al. EUS-guided gastroenterostomy is comparable to enteral stenting with fewer re-interventions in malignant gastric outlet obstruction. Surg Endosc 2017; 31: 2946-2952
  • 10 Tyberg A, Karia K, Zerbo S. et al. Endoscopic ultrasound-guided choledochojejunostomy with a lumen-apposing metal stent: a shortcut for biliary drainage. Endoscopy 2015; 47: E342-E343
  • 11 Tyberg A, Kumta N, Karia K. et al. EUS-guided gastrojejunostomy after failed enteral stenting. Gastrointest Endosc 2015; 81: 1011-1012
  • 12 Chen YI, Kunda R, Storm AC. et al. EUS-guided gastroenterostomy: a multicenter study comparing the direct and balloon-assisted techniques. Gastrointest Endosc 2018; 87: 1215-1221
  • 13 Itoi T, Tsuchiya T, Tonozuka R. et al. Novel EUS-guided double-balloon-occluded gastrojejunostomy bypass. Gastrointest Endosc 2016; 83: 461-462
  • 14 Khashab MA, Tieu AH, Azola A. et al. EUS-guided gastrojejunostomy for management of complete gastric outlet obstruction. Gastrointest Endosc 2015; 82: 745
  • 15 Chasen M, Bhargava R. Gastrointestinal symptoms, electrogastrography, inflammatory markers, and PG-SGA in patients with advanced cancer. Support Care Cancer 2012; 20: 1283-1290