Endoscopic ultrasound guided gastroenterostomy – a new alternative approach in patients with gastric outlet obstruction
DOI:
https://doi.org/10.5281/zenodo.15254579Keywords:
ЕUS-GE – Endoscopic ultrasound guided gastroenterostomy, GOO – gastric obstruction outlet syndrome, LAMS – lumen opposing metal stentsAbstract
Interventional endoscopic ultrasound is a minimally invasive therapeutic procedure with a variety of indications – pancreatic fluid collections drainage, biliary drainage after failed endoscopic retrograde cholangio-pancreatography, gallbladder drainage in patients who are contraindicated for surgery, coeliac plexus neurolysis, radio frequency ablation in biliopancreatic oncological conditions.
The development of new device senables the opportunity of evolving innovative procedures. Endoscopic ultrasound–guided gastroenterostomy (EUS-GE) is the creation of an endoscopic, non-surgical and stable anastomosis. EUS-GE is a feasible, safe and effective procedure according to meta-analyses, clinical trials and retrospective analyses of the experience of leading tertiary centers.
It’s an alternative to surgery and standard endoscopic stent placement. Thus EUS-GE guarantees enteral feeding. The aim of this article is to present our own clinical experience based on and compared to the literature data, as well as to the main steps of the technique, the possible post procedural complications and their management.
References
1. CarbajoAY, Kahaleh Met al. Clinical Review of EUS-guided Gastroenterostomy (EUS-GE). Journal of Clinical Gastroenterology. 2020; 54 (1): 1-7.
2. Bomman S, Ghafoor A, Sanders DJ et al. Endoscopic ultrasound-guided gastroenterostomy versus surgical gastrojejunostomy in treatment of malignant gastric outlet obstruction: Systematic review and meta-analysis. EndoscInt Open. 2022; 10(4): E361–E368.
3. Ahmed O, Lee JH, Thompson CC, et al. AGA clinical practice update on the optimal management of the malignant alimentary tract obstruction: Expert review. Clin Gastroenterol Hepatol 2021;19:1780 8.
4. Tonozuka R, Tsuchiya T, Mukai S et al. Endoscopic Ultrasonography-Guided Gastroenterostomy Techniques for Treatment of Malignant Gastric Outlet Obstruction. ClinEndosc. 2020;53(5):510-518.
5. van WanrooijRLJ, VanellaG, BronswijkMet al. Endoscopic ultrasound-guided gastroenterostomy versus duodenal stenting for malignant gastric outlet obstruction: an international, multicenter, propensity score-matched comparison. Endoscopy2022; 54(11):1023-1031.
6. Bejjani M, Ghandour B, Subtil JS et al. Clinical and technical outcomes of patients undergoing endoscopic ultrasound-guided gastroenterostomy using 20-mm vs. 15-mm lumen-apposing metal stents . Endoscopy. 2022; 54(7):680-687.
7. Ghandour B.Classification, outcomes, and management of misdeployed stents during EUS-guided gastroenterostomy. GastrointestEndosc. 2022;95(1):80-89
8. Kochhar R, KochharS. Endoscopic balloon dilation for benign gastric outlet obstruction in adults. World J GastrointestEndosc. 2010; 2(1): 29–35.
9. ChenYI, JamesTW, Agarwal A et al. EUS-guided gastroenterostomy in management of benign gastric outlet obstruction.EndoscInt Open. 2018; 6(3): E363–E369.
10. van der MerweSW, van WanrooijRLJ, Bronswijk-Met al. Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) GuidelineEndoscopy 2022;54(2):185-205.
11. Shiomi H, Sakai A, Nakano R et al. Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop Syndrome.ClinEndosc 2021;54(6):810-817.
12. Pannala R, Brandabur JJ, Gan SI et al. Afferent limb syndrome and delayed GI problems afterpancreaticoduodenectomy for pancreatic cancer: single-center,14-year experience. Gastrointestinal Endosc. 2011; 74(2):295-302.
13. Bukhari M, Kowalski T, NietoJ et al. An international, multicenter, comparative trial of EUSguidedgastrogastrostomy- assisted ERCP versus enteroscopy-assistedERCP in patients with Rouxen-Y gastric bypass anatomy.Gastrointest Endosc. 2018;88(3):486-494.
14. Iqbal U, KharaHS, Hu Yet al. EUS-guided gastroenterostomy for the management of gastric outlet obstruction: A systematic review and meta-analysis. EndoscUltrasound 2020;9(1):16-23
15. Abbas A, Dolan RD, Bazarbashi AN, Thompson CC. Endoscopic ultrasound-guided gastroenterostomy versus surgical gastrojejunostomy for the palliation of gastric outlet obstruction in patients with peritoneal carcinomatosis. Endoscopy. 2022; 54(7):671-679.
