Comparative analysis of gastric emptying between patients undergoing EUS guided gastroenterostomy and enteral stent placement: A pilot analysis

Background: Previous studies show EUS-guided gastroenterostomy (EUS-GE) is better than enteral stents (ES) in terms of clinical success and need for reintervention in the long-term. Gastric atony and stent placement across tumor can lead to poor gastric emptying after ES placement. We aimed to compare gastric emptying across ES and EUS guided gastroenterostomy (EUS-GE) to assess benefit of EUS-GE over ES in the short-term. Methods: In this pilot study, patients who underwent ES or EUS-GE for palliation of gastric outlet obstruction were included. A Gastric Emptying Study was performed at two weeks after the procedure after consumption of semisolid test-meal (Indian porridge) labelled with Tc-Sulphur. Primary outcome was gastric emptying t1/2 between ES and EUS-GE. Results: Forty patients were included in this study (21 ES, 19 EUS-GE; mean age 54 years, 27 males). EUS-GE had faster emptying t1/2 as compared to ES (72 mins vs 118 mins) (p=0.02). Abnormal emptying was seen in fewer patients undergoing EUS-GE (5.3% vs 47.6% [ES]; p=0.004). Clinical success at 2 weeks and reintervention at 6 months was not different. Conclusion: EUS-GE was associated with better gastric emptying as compared to ES suggesting a benefit which may translate to clinical benefit even in the short-term.

Publikationsverlauf

Eingereicht: 20. Februar 2025

Angenommen nach Revision: 10. April 2025

Accepted Manuscript online:
14. April 2025