Endoscopic ultrasound-guided entero-enterostomy for the treatment of afferent loop syndrome: A multicenter experience

Olaya I. Brewer Gutierrez, Shayan S. Irani, Saowanee Ngamruengphong, Hanaa D. Aridi, Rastislav Kunda, Ali Siddiqui, Markus Dollhopf, Jose Nieto, Yen I. Chen, Nadav Sahar, Majidah A. Bukhari, Omid Sanaei, Marcia I. Canto, Vikesh K. Singh, Richard Kozarek, Mouen A. Khashab

Research output: Contribution to journalArticlepeer-review

Abstract

Background Afferent loop syndrome (ALS) is traditionally managed surgically and, more recently, endoscopically. The role of endoscopic ultrasound-guided entero-enterostomy (EUS-EE) has not been well described. The aim of this study was to assess the technical and clinical success and safety of EUS-EE. Methods This was a multicenter, retrospective series at six centers in patients with ALS treated by EUS-EE. Data on patients treated with enteroscopy-assisted luminal stenting (EALS) at a single center were also collected. Results 18 patients (mean age 64.2 years, 72% post-pancreaticoduodenectomy, 10 female) underwent EUS-EE. The most common symptoms were vomiting (27.8%) and jaundice (33.3%). Clinical success included resolution of symptoms in 88.9% and improvement to allow hospital discharge in 11.1%. Technical success was achieved in 100% of cases, with a mean procedure time of 29.7 minutes. The most common procedure was a gastro-jejunostomy (72.2%). Three adverse events (16.7%) occurred (two mild, one moderate). When compared with data on EALS, patients treated with EUS-EE needed fewer re-interventions (16.6% vs. 76.5%; P <0.001). Conclusion EUS-EE seems to be safe and effective in the treatment of ALS.Indirect comparison with EALS suggested that EUS-EE is associated with a reduced need for re-intervention.

Original languageEnglish (US)
Pages (from-to)891-895
Number of pages5
JournalEndoscopy
Volume50
Issue number9
DOIs
StatePublished - Mar 2 2018

ASJC Scopus subject areas

  • Gastroenterology

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