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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(11): E1690-E1697
DOI: 10.1055/a-1221-9656
Original article

Safety and efficacy of endoscopic ultrasound-guided gastroenterostomy using double balloon occlusion methods: a clinical retrospective study in 36 patients with malignant gastric outlet obstruction

Guifang Xu‡
1   Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School
,
Yonghua Shen‡
1   Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School
,
Ying Lv
1   Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School
,
Xiaoliang Zhou
1   Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School
,
Wen Li
1   Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School
,
Yi Wang
1   Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School
,
Shahzeb Hassan
2   Northwestern University Feinberg School of Medicine, Chicago 60611, IL, United States
,
Lei Wang
1   Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School
,
Xiaoping Zou
1   Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School
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Abstract

Background and study aims Gastric outlet obstruction (GOO) is common in the late stage of many malignant tumors of the digestive system. Endoscopic ultrasound (EUS)-guided gastroenterostomy (EUS-GE) is commonly used for palliative treatment of malignant GOO. The objective of this study was to investigate the safety, efficacy, and prognosis of EUS-GE in treatment of malignant GOO in Chinese patients.

Patients and methods This was a retrospective, single-center study with 36 consecutive patients with malignant GOO who were treated with EUS-GE. The main outcome measures were technical success rate, clinical success rate, incidence of adverse events (AEs), and median survival time.

Results A total of 36 patients with malignant GOO underwent double-balloon-assisted EUS-GE between March 2017 and June 2019 in our hospital. GOO occurred mainly in elderly men (mean age 69.0 years, M:F 0.89). The most common etiology of GOO was pancreatic cancer (41.7 %). The most common obstruction site was the second part of the duodenum (63.9 %). The technical success rate was 100 % (36/36). The clinical success rate was 94.4 % (34/36). Median time for the total procedure was 52 minutes (range 34 – 156 min). Median time for determination of puncture site was 20 minutes (range 15 – 28 min). Median time between puncture and successful delivery of the stent was 38 minutes (range 19 – 128 min). The GOOSS score was 0.2 before EUS-GE. The GOO Scoring System (GOOSS) score was 2.2 at 15 days after the EUS-GE (P = 0.001). The GOOSS score was still higher than 2 during a median follow-up period of 89 days. AEs were observed in nine patients (25.0 %) and 13 total AEs occurred. One patient died as a result of delayed stent migration and bleeding. Mean length of hospital stay was 5.8 ± 4.7 days. The median survival period was 103 days. The rate of GOO recurrence was 2.7 % (1/36).

Conclusion EUS-GE was associated with increased safety and efficacy for treatment of malignant GOO in Chinese Mainland.



Publication History

Received: 10 December 2019

Accepted: 30 June 2020

Article published online:
22 October 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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