TY - JOUR
T1 - EUS-guided gastroenterostomy
T2 - a multicenter study comparing the direct and balloon-assisted techniques
AU - Chen, Yen I.
AU - Kunda, Rastislav
AU - Storm, Andrew C.
AU - Aridi, Hanaa Dakour
AU - Thompson, Christopher C.
AU - Nieto, Jose
AU - James, Theodore
AU - Irani, Shayan
AU - Bukhari, Majidah
AU - Gutierrez, Olaya Brewer
AU - Agarwal, Amol
AU - Fayad, Lea
AU - Moran, Robert
AU - Alammar, Nuha
AU - Sanaei, Omid
AU - Canto, Marcia I.
AU - Singh, Vikesh K.
AU - Baron, Todd H.
AU - Khashab, Mouen A.
N1 - Publisher Copyright:
© 2018 American Society for Gastrointestinal Endoscopy
PY - 2018/5
Y1 - 2018/5
N2 - Background: EUS-guided gastroenterostomy (EUS-GE) is a developing modality in the management of gastric outlet obstruction (GOO) with several technical approaches, including the direct and balloon-assisted techniques. The aim of this study was to compare the direct with the balloon-assisted modality while further defining the role of EUS-GE in GOO. Methods: This multicenter, retrospective study involved consecutive patients who underwent EUS-GE with the direct or balloon-assisted technique for GOO (January 2014 to October 2016). The primary outcome was technical success. Secondary outcomes were success (ability to tolerate at least a full fluid diet), procedure time, and rate/severity of adverse events (AEs). Results: A total of 74 patients (44.6% women; mean age 63.0 ± 11.7 years) underwent EUS-GE for GOO (direct gastroenterostomy, n = 52; balloon-assisted gastroenterostomy, n = 22). GOO was of malignant and benign etiology in 66.2% and 33.8% of patients, respectively. Technical success was achieved in 94.2% of the direct and 90.9% of the balloon-assisted approach (P =.63). Mean procedure time was shorter with the direct technique (35.7 ± 32.1 minutes vs 89.9 ± 33.3 minutes, P <.001). The clinical success rate was 92.3% for the direct technique and 90.9% for the balloon-assisted modality (P = 1.00), with a mean time to oral intake of 1.32 ± 2.76 days. The AE rate was 6.8% with only 1 severe AE noted. Rate of AEs, postprocedure length of stay, need for reintervention, and survival were similar between the 2 groups. Conclusions: EUS-GE is effective and safe in the management of GOO. The direct technique may be the preferred method given its shorter procedure time when compared with the balloon-assisted approach. Prospective trials are needed to confirm these findings.
AB - Background: EUS-guided gastroenterostomy (EUS-GE) is a developing modality in the management of gastric outlet obstruction (GOO) with several technical approaches, including the direct and balloon-assisted techniques. The aim of this study was to compare the direct with the balloon-assisted modality while further defining the role of EUS-GE in GOO. Methods: This multicenter, retrospective study involved consecutive patients who underwent EUS-GE with the direct or balloon-assisted technique for GOO (January 2014 to October 2016). The primary outcome was technical success. Secondary outcomes were success (ability to tolerate at least a full fluid diet), procedure time, and rate/severity of adverse events (AEs). Results: A total of 74 patients (44.6% women; mean age 63.0 ± 11.7 years) underwent EUS-GE for GOO (direct gastroenterostomy, n = 52; balloon-assisted gastroenterostomy, n = 22). GOO was of malignant and benign etiology in 66.2% and 33.8% of patients, respectively. Technical success was achieved in 94.2% of the direct and 90.9% of the balloon-assisted approach (P =.63). Mean procedure time was shorter with the direct technique (35.7 ± 32.1 minutes vs 89.9 ± 33.3 minutes, P <.001). The clinical success rate was 92.3% for the direct technique and 90.9% for the balloon-assisted modality (P = 1.00), with a mean time to oral intake of 1.32 ± 2.76 days. The AE rate was 6.8% with only 1 severe AE noted. Rate of AEs, postprocedure length of stay, need for reintervention, and survival were similar between the 2 groups. Conclusions: EUS-GE is effective and safe in the management of GOO. The direct technique may be the preferred method given its shorter procedure time when compared with the balloon-assisted approach. Prospective trials are needed to confirm these findings.
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U2 - 10.1016/j.gie.2017.07.030
DO - 10.1016/j.gie.2017.07.030
M3 - Article
C2 - 28750837
AN - SCOPUS:85041524957
SN - 0016-5107
VL - 87
SP - 1215
EP - 1221
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 5
ER -