Endoscopy 2020; 52(S 01): S106
DOI: 10.1055/s-0040-1704327
ESGE Days 2020 oral presentations
Friday, April 24, 2020 17:00 – 18:30 Biliary diseases Liffey Hall 2
© Georg Thieme Verlag KG Stuttgart · New York

OUTCOMES OF BILIO-PANCREATIC EUS IN PATIENTS WITH SURGICALLY ALTERED UPPER GI ANATOMY: A RETROSPECTIVE MULTICENTER STUDY

SF Crinò
1   University of Verona, Digestive Endoscopy Unit, Verona, Italy
,
L Brozzi
1   University of Verona, Digestive Endoscopy Unit, Verona, Italy
,
MC Petrone
2   San Raffaele Scientific Institute IRCCS, Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, Milano, Italy
,
JW Poley
3   Erasmus MC, University Medical Centre, Department of Gastroenterology and Hepatology, Rotterdam, Netherlands
,
S Carrara
4   Humanitas Clinical and Research Center IRCCS, Digestive Endoscopy Unit, Division of Gastroenterology, Milano, Italy
,
L Barresi
5   IRCCS-ISMETT (Mediterranean Institute for Transplantation and Highly Specialized Therapies), Endoscopy Service, Department of Diagnostic and Therapeutic Services, Palermo, Italy,
,
C Fabbri
6   Forli-Cesena Hospital, AUSL Romagna, Unit of Gastroenterology and Digestive Endoscopy, Forli-Cesena, Italy
,
M Rimbas
7   Colentina Clinical Hospital, Carol Davila University of Medicine, Gastroenterology Department, Bucharest, Romania
,
CD Angelis
8   Città della Salute e della Scienza di Torino, Gastroenterology and Digestive Endoscopy Unit, Torino, Italy
,
PG Arcidiacono
2   San Raffaele Scientific Institute IRCCS, Pancreato-Biliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, Milano, Italy
,
M Signoretti
3   Erasmus MC, University Medical Centre, Department of Gastroenterology and Hepatology, Rotterdam, Netherlands
,
L Lamonaca
4   Humanitas Clinical and Research Center IRCCS, Digestive Endoscopy Unit, Division of Gastroenterology, Milano, Italy
,
I Barbuscio
5   IRCCS-ISMETT (Mediterranean Institute for Transplantation and Highly Specialized Therapies), Endoscopy Service, Department of Diagnostic and Therapeutic Services, Palermo, Italy,
,
C Binda
6   Forli-Cesena Hospital, AUSL Romagna, Unit of Gastroenterology and Digestive Endoscopy, Forli-Cesena, Italy
,
A Gheorghe
7   Colentina Clinical Hospital, Carol Davila University of Medicine, Gastroenterology Department, Bucharest, Romania
,
S Rizza
8   Città della Salute e della Scienza di Torino, Gastroenterology and Digestive Endoscopy Unit, Torino, Italy
,
A Gabbrielli
1   University of Verona, Digestive Endoscopy Unit, Verona, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 

Aims Little is known about outcomes of bilio-pancreatic endosonography (EUS) in patients with surgically altered upper gastrointestinal (GI) anatomy. We aimed to assess the performance of EUS, the rate of procedural success and of EUS-related adverse events (AEs), according to post-surgical anatomies.

Methods Patients with post-surgical altered upper GI anatomy who underwent EUS for the evaluation of the bilio-pancreatic region between January 2008 and June 2018 in 8 European centers were included.

Results Of 242 patients (162 males, mean age 66.4 ± 12.5), 86 had (35.5%) Billroth II (BII), 77 (31.8%) duodenopancreatectomy, 23 (9.5%) Billroth I, 19 (7.9%) distal esophagectomy, 15 (6.2%) total gastrectomy, 14 (5.8%) sleeve gastrectomy, and 8 (3.3%) Roux-en-Y. Sleeve gastrectomy, BI, and duodenopancreatectomy were associated with the highest rate of success (100%, 95.7%, and 92.2%, respectively). Head of pancreas visualization was significantly impacted by total gastrectomy, BII, and Roux-en-Y (success rate 6.7%, 53.7%, and 57.1%, respectively). The pancreatic body and tail were correctly examined in more than 90% of the cases in all groups except for esophagectomy and total gastrectomy patients (82.4% and 71.4%, respectively). The overall technical success of EUS-guided tissue acquisition (TA) was 78.2% (68/87 cases): 16 lesions failed to be visualized whereas in 5 it was impossible to puncture the lesion, resulting in a diagnostic accuracy of 71.3% (95% CI, 60.6-80.5).

Four (1.6%) AEs were observed: 1 mucosal tearing in a BII patient, 1 cardiac arrest in a distal esophagectomy patient, 1 bleeding after EUS-TA in a BI patient, and 1 acute pancreatitis after EUS-TA in a sleeve gastrectomy patient.

Conclusions The yield of bilio-pancreatic EUS in surgically altered upper GI anatomy is dependent on lesion location and surgery type. Before considering EUS in these patients, one must carefully consider the location of the target lesion and if it could be approachable by EUS.