Double endoscopic bypass for gastric outlet obstruction and biliary obstruction
Background and study aims Double endoscopic bypass entails EUS-guided gastroenterostomy (EUS-GE) and EUS-guided biliary drainage (EUS-BD) in patients who present with gastric outlet and biliary obstruction. We report a multicenter experience with double endoscopic bypass. Patients and met...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2017-09-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-115386 |
| _version_ | 1818419642903822336 |
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| author | Olaya I. Brewer Gutierrez Jose Nieto Shayan Irani Theodore James Renata Pieratti Bueno Yen-I Chen Majidah Bukhari Omid Sanaei Vivek Kumbhari Vikesh K. Singh Saowanee Ngamruengphong Todd H. Baron Mouen A. Khashab |
| author_facet | Olaya I. Brewer Gutierrez Jose Nieto Shayan Irani Theodore James Renata Pieratti Bueno Yen-I Chen Majidah Bukhari Omid Sanaei Vivek Kumbhari Vikesh K. Singh Saowanee Ngamruengphong Todd H. Baron Mouen A. Khashab |
| author_sort | Olaya I. Brewer Gutierrez |
| collection | DOAJ |
| description | Background and study aims Double endoscopic bypass entails EUS-guided gastroenterostomy (EUS-GE) and EUS-guided biliary drainage (EUS-BD) in patients who present with gastric outlet and biliary obstruction. We report a multicenter experience with double endoscopic bypass.
Patients and methods Retrospective, multicenter series involving 3 US centers. Patients who underwent double endoscopic bypass for malignant gastric and biliary obstruction from 1/2015 to 12/2016 were included. Primary outcome was clinical success defined as tolerance of oral intake and resolution of cholestasis. Secondary outcomes included technical success, re-interventions and adverse events (AE).
Results Seven patients with pancreatic head cancer (57.1 % females; mean age 64.6 ± 12.5 years) underwent double endoscopic bypass. Four patients had EUS-GE and EUS-BD performed during the same session with a mean procedure time of 70 ± 20.4 minutes. EUS-GE and EUS-BD were technically successful in all patients, all of whom were able to tolerate oral intake with resolution of cholestasis in 6 (87.5 %). One patient had a repeat EUS-BD with normalization of bilirubin. There were no adverse events.
Conclusions Double endoscopic bypass is feasible and effective when performed by experienced operators. Studies comparing this novel concept to existing techniques are warranted. |
| first_indexed | 2024-12-14T12:41:49Z |
| format | Article |
| id | doaj.art-11fb72d83c294822887caa8a24431c59 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-14T12:41:49Z |
| publishDate | 2017-09-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-11fb72d83c294822887caa8a24431c592022-12-21T23:00:54ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362017-09-010509E893E89910.1055/s-0043-115386Double endoscopic bypass for gastric outlet obstruction and biliary obstructionOlaya I. Brewer Gutierrez0Jose Nieto1Shayan Irani2Theodore James3Renata Pieratti Bueno4Yen-I Chen5Majidah Bukhari6Omid Sanaei7Vivek Kumbhari8Vikesh K. Singh9Saowanee Ngamruengphong10Todd H. Baron11Mouen A. Khashab12Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States Borland-Groover Clinic, Jacksonville, Florida, United StatesDivision of Gastroenterology and Hepatology, Virginia Mason Hospital, Seattle, Washington, United StatesDivision of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States Background and study aims Double endoscopic bypass entails EUS-guided gastroenterostomy (EUS-GE) and EUS-guided biliary drainage (EUS-BD) in patients who present with gastric outlet and biliary obstruction. We report a multicenter experience with double endoscopic bypass. Patients and methods Retrospective, multicenter series involving 3 US centers. Patients who underwent double endoscopic bypass for malignant gastric and biliary obstruction from 1/2015 to 12/2016 were included. Primary outcome was clinical success defined as tolerance of oral intake and resolution of cholestasis. Secondary outcomes included technical success, re-interventions and adverse events (AE). Results Seven patients with pancreatic head cancer (57.1 % females; mean age 64.6 ± 12.5 years) underwent double endoscopic bypass. Four patients had EUS-GE and EUS-BD performed during the same session with a mean procedure time of 70 ± 20.4 minutes. EUS-GE and EUS-BD were technically successful in all patients, all of whom were able to tolerate oral intake with resolution of cholestasis in 6 (87.5 %). One patient had a repeat EUS-BD with normalization of bilirubin. There were no adverse events. Conclusions Double endoscopic bypass is feasible and effective when performed by experienced operators. Studies comparing this novel concept to existing techniques are warranted.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-115386 |
| spellingShingle | Olaya I. Brewer Gutierrez Jose Nieto Shayan Irani Theodore James Renata Pieratti Bueno Yen-I Chen Majidah Bukhari Omid Sanaei Vivek Kumbhari Vikesh K. Singh Saowanee Ngamruengphong Todd H. Baron Mouen A. Khashab Double endoscopic bypass for gastric outlet obstruction and biliary obstruction Endoscopy International Open |
| title | Double endoscopic bypass for gastric outlet obstruction and biliary obstruction |
| title_full | Double endoscopic bypass for gastric outlet obstruction and biliary obstruction |
| title_fullStr | Double endoscopic bypass for gastric outlet obstruction and biliary obstruction |
| title_full_unstemmed | Double endoscopic bypass for gastric outlet obstruction and biliary obstruction |
| title_short | Double endoscopic bypass for gastric outlet obstruction and biliary obstruction |
| title_sort | double endoscopic bypass for gastric outlet obstruction and biliary obstruction |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-115386 |
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