TY - JOUR
T1 - An international, multicenter, comparative trial of EUS-guided gastrogastrostomy-assisted ERCP versus enteroscopy-assisted ERCP in patients with Roux-en-Y gastric bypass anatomy
AU - Bukhari, Majidah
AU - Kowalski, Thomas
AU - Nieto, Jose
AU - Kunda, Rastislav
AU - Ahuja, Nitin K.
AU - Irani, Shayan
AU - Shah, Apeksha
AU - Loren, David
AU - Brewer, Olaya
AU - Sanaei, Omid
AU - Chen, Yen I.
AU - Ngamruengphong, Saowanee
AU - Kumbhari, Vivek
AU - Singh, Vikesh
AU - Aridi, Hanaa Dakour
AU - Khashab, Mouen A.
N1 - Publisher Copyright:
© 2018 American Society for Gastrointestinal Endoscopy
PY - 2018/9
Y1 - 2018/9
N2 - Background and Aims: ERCP is challenging in patients with Roux-en-Y gastric bypass (RYGB) anatomy. EUS-guided gastrogastrostomy (GG) creation is a promising novel technique to access the excluded stomach to facilitate conventional ERCP. We aimed to compare procedural outcomes and adverse events (AEs) between EUS-guided GG-assisted ERCP (EUS-GG-ERCP) and enteroscopy-assisted ERCP (e-ERCP) in patients with RYGB. Methods: Patients with RYGB anatomy who underwent EUS-GG-ERCP or e-ERCP between 2014 and 2016 at 5 tertiary centers were included. The primary outcome was technical success of ERCP, defined as successful cannulation of the selected duct with successful intervention as intended. Secondary outcomes included total procedural time (in the EUS-GG group, total procedural time included EUS-GG creation plus ERCP procedure time), length of hospital stay, and rate/severity of AEs graded according to the American Society for Gastrointestinal Endoscopy lexicon. Results: A total of 60 patients (mean age, 57.2 ± 13.2; 75% women) were included, of whom 30 (50%) underwent EUS-GG-ERCP and 30 (50%) underwent e-ERCP (double-balloon enteroscope ERCP, 19; single-balloon enteroscope ERCP, 11). The technical success rate was significantly higher in the EUS-GG-ERCP versus the e-ERCP group (100% vs 60.0%, P <.001). Total procedure time was significantly shorter in patients who underwent EUS-GG-ERCP (49.8 minutes vs 90.7 minutes, P <.001). Postprocedure median length of hospitalization was shorter in the EUS-GG group (1 vs 10.5 days, P =.02). Rate of AEs was similar in both groups (10% vs 6.7%, P = 1). Conclusions: EUS-GG-ERCP may be superior to e-ERCP in patients with RYGB anatomy in terms of a higher technical success and shorter procedural times and offers a similar safety profile.
AB - Background and Aims: ERCP is challenging in patients with Roux-en-Y gastric bypass (RYGB) anatomy. EUS-guided gastrogastrostomy (GG) creation is a promising novel technique to access the excluded stomach to facilitate conventional ERCP. We aimed to compare procedural outcomes and adverse events (AEs) between EUS-guided GG-assisted ERCP (EUS-GG-ERCP) and enteroscopy-assisted ERCP (e-ERCP) in patients with RYGB. Methods: Patients with RYGB anatomy who underwent EUS-GG-ERCP or e-ERCP between 2014 and 2016 at 5 tertiary centers were included. The primary outcome was technical success of ERCP, defined as successful cannulation of the selected duct with successful intervention as intended. Secondary outcomes included total procedural time (in the EUS-GG group, total procedural time included EUS-GG creation plus ERCP procedure time), length of hospital stay, and rate/severity of AEs graded according to the American Society for Gastrointestinal Endoscopy lexicon. Results: A total of 60 patients (mean age, 57.2 ± 13.2; 75% women) were included, of whom 30 (50%) underwent EUS-GG-ERCP and 30 (50%) underwent e-ERCP (double-balloon enteroscope ERCP, 19; single-balloon enteroscope ERCP, 11). The technical success rate was significantly higher in the EUS-GG-ERCP versus the e-ERCP group (100% vs 60.0%, P <.001). Total procedure time was significantly shorter in patients who underwent EUS-GG-ERCP (49.8 minutes vs 90.7 minutes, P <.001). Postprocedure median length of hospitalization was shorter in the EUS-GG group (1 vs 10.5 days, P =.02). Rate of AEs was similar in both groups (10% vs 6.7%, P = 1). Conclusions: EUS-GG-ERCP may be superior to e-ERCP in patients with RYGB anatomy in terms of a higher technical success and shorter procedural times and offers a similar safety profile.
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U2 - 10.1016/j.gie.2018.04.2356
DO - 10.1016/j.gie.2018.04.2356
M3 - Article
C2 - 29730228
AN - SCOPUS:85050154363
SN - 0016-5107
VL - 88
SP - 486
EP - 494
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 3
ER -