Initial Experience with Endoscopic Ultrasound-Guided Gastrojejunostomy: A Minimally Invasive Solution for Gastric Outlet Obstruction

Aims Endoscopic ultrasound-guided gastrojejunostomy (EUS-GY) has emerged as a minimally invasive alternative to surgical treatment for patients with gastric outlet obstruction. This retrospective study evaluates the initial experience of a tertiary hospital in performing EUS-GY for patients with various etiologies of gastric obstruction

Methods A total of 23 patients who underwent EUS-GY between November 2022 and September 2024 were included. Demographic characteristics, obstruction etiologies, technical and clinical success rates, and immediate adverse events were analyzed. Technical success was defined as the correct placement of a lumen-apposing metal stent (LAMS), while clinical success was defined as the patient’s ability to tolerate an oral diet. Procedure-related adverse events were also recorded [1].

Results Of the 23 patients, 18 (78.3%) were male and 5 (21.7%) female, with a mean age of 70 years. Most cases of obstruction were of malignant origin (96%), with pancreaticobiliary (43.5%) and gastric cancers (43.5%) being the most common causes. The obstruction site was located in the antrum or pylorus in 10 patients, in the duodenal bulb or second portion in another 10, and in the distal duodenum in 3 cases. Technical and clinical success was achieved in 22 patients (95.6%). LAMS of 20x10 mm were used in 19 patients, while 15x10 mm stents were used in 3 cases. Adverse events occurred in 3 patients (13%) due to stent migration. Two cases were successfully managed endoscopically, while one required surgical intervention. All adverse events were resolved without persistent complications

Conclusions The initial experience with EUS-GY in our tertiary hospital demonstrates that the procedure is technically feasible and safe, with high rates of clinical and technical success and a low incidence of immediate complications. These findings support the use of EUS-GY as an effective and minimally invasive therapeutic option for patients with gastric outlet obstruction.

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

• References

• 1 Antonelli G, Kovacevic B, Karstensen JG. et al. Endoscopic ultrasound-guided gastro-enteric anastomosis: A systematic review and meta-analysis. Dig Liver Dis 2020; 52 (11): 1294-1301

Publication History

Article published online:
27 March 2025