Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction

Janine B. Kastelijn, Leon M. G. Moons, Francisco J. Garcia-Alonso, Manuel Perez-Miranda, Viliam Masaryk, Uwe Will, Ilaria Tarantino, Hendrik M. van Dullemen, Rina Bijlsma, Jan-Werner Poley, Matthijs P. Schwartz, Frank P. Vleggaar*

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

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Background and study aims Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) with a lumen-apposing metal stent (LAMS) is a novel, minimally invasive technique in the palliative treatment of malignant gastric outlet obstruction (GOO). Several studies have demonstrated feasibility and safety of EUS-GE, but evidence on long-term durability is limited. The aim of this study was to evaluate patency of EUS-GE in treatment of malignant GOO.

Patients and Methods An international multicenter study was performed in seven centers in four European countries. Patients who underwent EUS-GE with a LAMS between March 2015 and March 2019 for palliative treatment of symptomatic malignant GOO were included retrospectively. Our main outcome was recurrent obstruction due to LAMS dysfunction; other outcomes of interest were technical success, clinical success, adverse events (AEs), and survival.

Results A total of 45 patients (mean age 69.9 +/- 12.3 years and 48.9 % male) were included. Median duration of follow-up was 59 days (interquartile range [IQR] 41-128). Recurrent obstruction occurred in two patients (6.1 %), after 33 and 283 days of follow-up. Technical success was achieved in 39 patients (86.7 %). Clinical success was achieved in 33 patients (73.3 %). AEs occurred in 12 patients (26.7 %), yof which five were fatal. Median overall survival was 57 days (IQR 32-114).

Conclusions EUS-GE showed a low rate of recurrent obstruction. The relatively high number of fatal AEs underscores the importance of careful implementation of EUS-GE in clinical practice.

Originele taal-2English
Pagina's (van-tot)E1194-E1201
Aantal pagina's8
TijdschriftEndoscopy international open
Nummer van het tijdschrift09
StatusPublished - sep-2020

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