Endoscopy 2021; 53(S 01): S241-S242
DOI: 10.1055/s-0041-1724929
Abstracts | ESGE Days
ESGE Days 2021 Digital poster exhibition

Impact On Nutritional Status Of Eus-Guided Gastroenterostomy In Patients With A Malignant Duodenal Stenosis

E Perez-Cuadrado Robles
1   Georges-Pompidou European Hospital, Gastroenterology, Paris, France
,
G Perrod
1   Georges-Pompidou European Hospital, Gastroenterology, Paris, France
,
H Benosman
1   Georges-Pompidou European Hospital, Gastroenterology, Paris, France
,
E Moati
2   Georges-Pompidou European Hospital, Oncology, Paris, France
,
E Coffin
3   Georges-Pompidou European Hospital, Gastroenterology, PARIS, France
,
J Taieb
2   Georges-Pompidou European Hospital, Oncology, Paris, France
,
C Cellier
3   Georges-Pompidou European Hospital, Gastroenterology, PARIS, France
,
G Rahmi
3   Georges-Pompidou European Hospital, Gastroenterology, PARIS, France
› Institutsangaben
 
 

    Aims The endoscopic ultrasound guided gastroenterostomy (EUS-GE) is an alternative to the duodenal stent in patients with a malignant stenosis. This challenging technique may have larger patency times with a lower reintervention rate compared to duodenal stents at expenses of a higher intraoperative complication rate. However, the impact on nutritional status in these patients is unknown.

    Methods Observational single-center study. All consecutive patients who underwent a EUS-GE in 2020 because of a malignant gastric outlet syndrome were included. A lumen apposing metal stent of 20mm was used. Clinical and biological variables and nutritional status were measured 48h before the procedure and for 3 months follow-up.

    Results Seventeen patients underwent a EUS-GE. Seven were excluded because the purpose of the technique was not for alimentation but drainage of malignant afferent limb syndrome or access to excluded jejunal limb in post-surgical anatomy. Dix patients (mean age: 64±13,73yr, 50 % male) with a pancreatic cancer (n = 7, 70 %), cholangiocarcinoma (n = 1, 10 %), gastric cancer (n = 1, 10 %) or neuroendocrine tumor (n = 1, 10 %) were finally included.

    Before the procedure, the median OMS index was 1 (range:0-2) and a metastatic disease or carcinosis were confirmed in 3 (30 %) and 2 (20 %) cases. A previous duodenal stent was present in 60 % of cases.

    The technical success was 80 % with a direct access (n = 7) or guidewire assisted (n = 3) techniques. Clinical success was 100 % with a normal oral diet (n = 7, 87.5 %) or mixed oral diet (n = 1, 12.5 %) 48h after the procedure. Enteral nutrition was left in place in only two cases (20 %). No complications, reintervention rate or mortality. An improvement of the weight (55kg vs. 53kg,p = 0.043) and BMI (20.8 kg/m2 vs. 19.98 kg/m2,p = 0.043) were confirmed (Table 1).

    Tab. 1

    Variable

    Before EUS-GE (48h)

    Follow-up

    P-value

    Leucocytes (g/L)

    6.95 (4.1-19.4)

    9,6 (4,7-12,4)

    0.686

    Albumin (d/L)

    30,5 (22-39)

    34,5 (22-37)

    0.336

    Weight (kg)

    53 (48-65)

    55 (49,5-69)

    0.043*

    BMI (kg/m2)

    19,98 (17,6-22,7)

    20,8 (18,2-24,4)

    0.043*

    Conclusions EUS-GE is a safe technique with high technical and clinical success improving the nutritional status and allowing to withdraw complementary enteral nutrition.

    Citation Perez-Cuadrado Robles E, Perrod G, Benosman H et al. eP439 IMPACT ON NUTRITIONAL STATUS OF EUS-GUIDED GASTROENTEROSTOMY IN PATIENTS WITH A MALIGNANT DUODENAL STENOSIS. Endoscopy 2021; 53: S241.


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    Artikel online veröffentlicht:
    19. März 2021

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