Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience
Background: Endoscopic-ultrasound-guided gastrojejunostomy (EUS-GJ) can be a new alternative for patients with malignant afferent loop syndrome (MALS). However, a fully covered self-expandable metal stent (FCSEMS) has not been well investigated in this setting. Methods: This is a multicenter retrosp...
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MDPI AG
2023-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/10/3524 |
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| author | Saburo Matsubara Sho Takahashi Naminatsu Takahara Keito Nakagawa Kentaro Suda Takeshi Otsuka Yousuke Nakai Hiroyuki Isayama Masashi Oka Sumiko Nagoshi |
| author_facet | Saburo Matsubara Sho Takahashi Naminatsu Takahara Keito Nakagawa Kentaro Suda Takeshi Otsuka Yousuke Nakai Hiroyuki Isayama Masashi Oka Sumiko Nagoshi |
| author_sort | Saburo Matsubara |
| collection | DOAJ |
| description | Background: Endoscopic-ultrasound-guided gastrojejunostomy (EUS-GJ) can be a new alternative for patients with malignant afferent loop syndrome (MALS). However, a fully covered self-expandable metal stent (FCSEMS) has not been well investigated in this setting. Methods: This is a multicenter retrospective cohort study. Consecutive patients that underwent EUS-GJ using a FCSEMS for MALS between April 2017 and November 2022 were enrolled. Primary outcomes were technical and clinical success rates. Secondary outcomes were adverse events, recurrent symptoms, and overall survival. Results: Twelve patients (median age: 67.5 years (interquartile range: 58–74.8); 50% male) were included. The most common primary disease and type of previous surgery were pancreatic cancer (67%) and pancreatoduodenectomy (75%), respectively. Technical success and clinical success were achieved in all patients. Procedure-related adverse events occurred in one patient (8%) with mild peritonitis. During a median follow-up of 96.5 days, one patient (8%) had recurrent symptoms due to the EUS-GJ stent dysfunction; including biliary events unrelated to the EUS-GJ stent, five patients (42%) had recurrent events. The median overall survival was 137 days. Nine patients (75%) died due to disease progression. Conclusions: EUS-GJ with a FCSEMS seems safe and effective for MALS with high technical and clinical success rates and an acceptable recurrence rate. |
| first_indexed | 2024-03-11T03:37:39Z |
| format | Article |
| id | doaj.art-915eb43ca3bc4949ad3bcc3eaa44b2fd |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T03:37:39Z |
| publishDate | 2023-05-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-915eb43ca3bc4949ad3bcc3eaa44b2fd2023-11-18T01:54:28ZengMDPI AGJournal of Clinical Medicine2077-03832023-05-011210352410.3390/jcm12103524Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter ExperienceSaburo Matsubara0Sho Takahashi1Naminatsu Takahara2Keito Nakagawa3Kentaro Suda4Takeshi Otsuka5Yousuke Nakai6Hiroyuki Isayama7Masashi Oka8Sumiko Nagoshi9Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Saitama 350-8550, JapanDepartment of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Saitama 350-8550, JapanDepartment of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Saitama 350-8550, JapanDepartment of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Saitama 350-8550, JapanDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, JapanDepartment of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo 113-8431, JapanDepartment of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Saitama 350-8550, JapanDepartment of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Saitama 350-8550, JapanBackground: Endoscopic-ultrasound-guided gastrojejunostomy (EUS-GJ) can be a new alternative for patients with malignant afferent loop syndrome (MALS). However, a fully covered self-expandable metal stent (FCSEMS) has not been well investigated in this setting. Methods: This is a multicenter retrospective cohort study. Consecutive patients that underwent EUS-GJ using a FCSEMS for MALS between April 2017 and November 2022 were enrolled. Primary outcomes were technical and clinical success rates. Secondary outcomes were adverse events, recurrent symptoms, and overall survival. Results: Twelve patients (median age: 67.5 years (interquartile range: 58–74.8); 50% male) were included. The most common primary disease and type of previous surgery were pancreatic cancer (67%) and pancreatoduodenectomy (75%), respectively. Technical success and clinical success were achieved in all patients. Procedure-related adverse events occurred in one patient (8%) with mild peritonitis. During a median follow-up of 96.5 days, one patient (8%) had recurrent symptoms due to the EUS-GJ stent dysfunction; including biliary events unrelated to the EUS-GJ stent, five patients (42%) had recurrent events. The median overall survival was 137 days. Nine patients (75%) died due to disease progression. Conclusions: EUS-GJ with a FCSEMS seems safe and effective for MALS with high technical and clinical success rates and an acceptable recurrence rate.https://www.mdpi.com/2077-0383/12/10/3524endoscopic ultrasoundgastrojejunostomyafferent loop syndrome |
| spellingShingle | Saburo Matsubara Sho Takahashi Naminatsu Takahara Keito Nakagawa Kentaro Suda Takeshi Otsuka Yousuke Nakai Hiroyuki Isayama Masashi Oka Sumiko Nagoshi Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience Journal of Clinical Medicine endoscopic ultrasound gastrojejunostomy afferent loop syndrome |
| title | Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience |
| title_full | Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience |
| title_fullStr | Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience |
| title_full_unstemmed | Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience |
| title_short | Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience |
| title_sort | endoscopic ultrasound guided gastrojejunostomy for malignant afferent loop syndrome using a fully covered metal stent a multicenter experience |
| topic | endoscopic ultrasound gastrojejunostomy afferent loop syndrome |
| url | https://www.mdpi.com/2077-0383/12/10/3524 |
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