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Endoscopic ultrasound-guided gastrojejunostomy with wire endoscopic simplified technique: Move towards benign indications (with video).
Gonzalez, Jean-Michel; Ouazzani, Sohaib; Vanbiervliet, Geoffroy; Gasmi, Mohamed; Barthet, Marc.
Afiliación
  • Gonzalez JM; Department of Gastroenterology, Aix-Marseille Université, AP-HM, Hôpital Nord, Marseille, France.
  • Ouazzani S; Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Université Libre de Bruxelles (ULB), Erasme Hospital, Brussels, Belgium.
  • Vanbiervliet G; Department of Gastroenterology, CHU l'Archet II, Nice, France.
  • Gasmi M; Department of Gastroenterology, Aix-Marseille Université, AP-HM, Hôpital Nord, Marseille, France.
  • Barthet M; Department of Gastroenterology, Aix-Marseille Université, AP-HM, Hôpital Nord, Marseille, France.
Dig Endosc ; 2024 Sep 10.
Article en En | MEDLINE | ID: mdl-39253824
ABSTRACT

OBJECTIVES:

Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) is an alternative to duodenal stenting and surgical GJ (SGGJ) in malignant gastric outlet obstruction (MGOO). European Society of Gastrointestinal Endoscopy guidelines restricted EUS-GJ for MGOO only, because of misdeployment. The aim was to evaluate its outcomes focusing on benign indications.

METHODS:

This was a retrospective study conducted from 2016 to 2023 in a tertiary center. Patients included had malignant or benign GOO indicated for EUS-GJ. Techniques were the direct approach until August 2021, and the wire endoscopic simplified technique (WEST) afterwards. The main objective was to compare outcomes in benign vs. MGOO. Secondary end-points were technical success, adverse events rates, and describing the evolution of techniques and indications.

RESULTS:

In all, 87 patients were included, 46 men, mean age 66 ± 16.2 years. Indications were malignant in 60.1% and benign in 39.1%. The EUS-GJ technique was direct in 33 patients (37.9%) and WEST in 54 (62.1%). No difference was found in terms of technical, clinical, or adverse events rates. The initial technical success rate was 88.5%. The final technical and clinical success rates were 96.6% and 94.25%, respectively. In the last year, benign exceeded malignant indications (70.4% vs. 29.6%, P < 0.05). Seven misdeployments occurred, six being addressed with the rescue technique. The misdeployment rate was significantly decreased using the WEST approach compared to the direct one 3.7% vs. 18% (P < 0.05). The severe postoperative adverse events rate was 2.3%.

CONCLUSION:

This study demonstrated similar outcomes of EUS-GJ between benign and MGOO, with a decreasing misdeployment rate (<4%) applying WEST. This represents an additional step towards recommending EUS-GJ in benign indications.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Dig Endosc Asunto de la revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Dig Endosc Asunto de la revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Australia