Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction
Background and study aims EUS-guided gastroenterostomy (GE) is a novel, minimally invasive endoscopic procedure for the treatment of gastric outlet obstruction (GOO). The direct-EUS-GE (D-GE) approach has recently gained traction. We aimed to report on a large cohort of patients who underwent DGE wi...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2019-01-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-0799-9939 |
| _version_ | 1818200263760019456 |
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| author | Tossapol Kerdsirichairat Shayan Irani Juliana Yang Olaya I. Brewer Gutierrez Robert Moran Omid Sanaei Mohamad Dbouk Vivek Kumbhari Vikesh K. Singh Anthony N. Kalloo Mouen A. Khashab |
| author_facet | Tossapol Kerdsirichairat Shayan Irani Juliana Yang Olaya I. Brewer Gutierrez Robert Moran Omid Sanaei Mohamad Dbouk Vivek Kumbhari Vikesh K. Singh Anthony N. Kalloo Mouen A. Khashab |
| author_sort | Tossapol Kerdsirichairat |
| collection | DOAJ |
| description | Background and study aims EUS-guided gastroenterostomy (GE) is a novel, minimally invasive endoscopic procedure for the treatment of gastric outlet obstruction (GOO). The direct-EUS-GE (D-GE) approach has recently gained traction. We aimed to report on a large cohort of patients who underwent DGE with focus on long-term outcomes.
Patients and methods This two-center, retrospective study involved consecutive patients who underwent D-GE between October 2014 and May 2018. The primary outcomes were technical and clinical success. Secondary outcomes were adverse events (AEs), rate of reintervention, procedure time, time to resume oral diet, and post-procedure length of stay (LOS).
Results A total of 57 patients (50.9 % female; median age 65 years) underwent D-GE for GOO. The etiology was malignant in 84.2 % and benign in 15.8 %. Technical success and clinical success were achieved in 93 % and 89.5 % of patients, respectively, with a median follow-up of 196 days in malignant GOO and 319.5 days in benign GOO. There were 2 (3.5 %) AEs, one severe and one moderate. Median procedure time was 39 minutes (IQR, 26 – 51.5 minutes). Median time to resume oral diet after D-GE was 1 day (IQR 1 – 2 days). Median post D-GE LOS was 3 days (IQR 2 – 7 days). Rate of reintervention was 15.1 %.
Conclusions D-GE is safe and effective in management of both malignant and benign causes of GOO. Clinical success with D-GE is durable with a low rate of reintervention based on a long-term cohort. |
| first_indexed | 2024-12-12T02:34:53Z |
| format | Article |
| id | doaj.art-483ab638aa1043abad700f59b3ac7a08 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-12T02:34:53Z |
| publishDate | 2019-01-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-483ab638aa1043abad700f59b3ac7a082022-12-22T00:41:19ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362019-01-010702E144E15010.1055/a-0799-9939Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstructionTossapol Kerdsirichairat0Shayan Irani1Juliana Yang2Olaya I. Brewer Gutierrez3Robert Moran4Omid Sanaei5Mohamad Dbouk6Vivek Kumbhari7Vikesh K. Singh8Anthony N. Kalloo9Mouen A. Khashab10Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Virginia Mason Medical Center, Seattle, Washington, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, United StatesDivision of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, United StatesBackground and study aims EUS-guided gastroenterostomy (GE) is a novel, minimally invasive endoscopic procedure for the treatment of gastric outlet obstruction (GOO). The direct-EUS-GE (D-GE) approach has recently gained traction. We aimed to report on a large cohort of patients who underwent DGE with focus on long-term outcomes. Patients and methods This two-center, retrospective study involved consecutive patients who underwent D-GE between October 2014 and May 2018. The primary outcomes were technical and clinical success. Secondary outcomes were adverse events (AEs), rate of reintervention, procedure time, time to resume oral diet, and post-procedure length of stay (LOS). Results A total of 57 patients (50.9 % female; median age 65 years) underwent D-GE for GOO. The etiology was malignant in 84.2 % and benign in 15.8 %. Technical success and clinical success were achieved in 93 % and 89.5 % of patients, respectively, with a median follow-up of 196 days in malignant GOO and 319.5 days in benign GOO. There were 2 (3.5 %) AEs, one severe and one moderate. Median procedure time was 39 minutes (IQR, 26 – 51.5 minutes). Median time to resume oral diet after D-GE was 1 day (IQR 1 – 2 days). Median post D-GE LOS was 3 days (IQR 2 – 7 days). Rate of reintervention was 15.1 %. Conclusions D-GE is safe and effective in management of both malignant and benign causes of GOO. Clinical success with D-GE is durable with a low rate of reintervention based on a long-term cohort.http://www.thieme-connect.de/DOI/DOI?10.1055/a-0799-9939 |
| spellingShingle | Tossapol Kerdsirichairat Shayan Irani Juliana Yang Olaya I. Brewer Gutierrez Robert Moran Omid Sanaei Mohamad Dbouk Vivek Kumbhari Vikesh K. Singh Anthony N. Kalloo Mouen A. Khashab Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction Endoscopy International Open |
| title | Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction |
| title_full | Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction |
| title_fullStr | Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction |
| title_full_unstemmed | Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction |
| title_short | Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction |
| title_sort | durability and long term outcomes of direct eus guided gastroenterostomy using lumen apposing metal stents for gastric outlet obstruction |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-0799-9939 |
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