Eus Guided Gastrojejunostomy For The Management Of Gastric Outlet Obstruction: a Single Centre Experience

Aims There are various modalities of management of gastric outlet obstruction (GOO) namely endoscopic enteral stenting, surgical bypass or placement of a venting gastrostomy tube. Endoscopic ultrasound guided gastrojejunostomy (EUS-GJ) via placement of a lumen apposing metal stent has recently emerged as a viable and effective method of managing GOO. We aimed to describe the procedural characteristics, technical and clinical outcomes in patients who underwent EUS-GJ at our institution.

Methods A prospectively collected database of consecutive EUS-GJ procedures from August 2018 to October 2020 at our institution was reviewed retrospectively. All procedures were performed by two expert pancreatobiliary endoscopists. Recorded variables included patient demographics, technical success, clinical success, adverse events, 30-day all cause mortality and follow-up duration.

Results Sixteen patients (9 males) with a mean age of 64.5 years old (range 48 – 80 years old) were identified. Malignancy was the predominant aetiology of GOO in our patient cohort (81.3 %, n=13). The technical success rate (defined as fluoroscopic and endoscopic confirmation of adequate stent deployment and positioning) was 93.8 % (n=15), in whom the clinical success rate (defined as toleration of at least liquid diet without vomiting before discharge) was 100 %. In the solitary case of technical failure, dislodgement occurred during balloon dilatation of the stent, the defect was endoscopically closed with clips and a duodenal stent was placed. The patient did not experience any adverse consequences post-procedure. Nine patients who required intravenous parenteral nutrition pre-procedure were successfully weaned off following EUS-GJ. The median follow-up was 109 days (range 5 – 383 days). No adverse events were encountered. One patient required re-intervention at day 70. 30-day all cause mortality was 6.3 % (n=1) and the death was due to malignant disease progression.

Conclusions EUS-GJ is an effective and safe procedure for the management of GOO. It should be considered in appropriately selected patients if there is available expertise.

Citation: On W, Huggett MT, Paranandi B. OP111 EUS GUIDED GASTROJEJUNOSTOMY FOR THE MANAGEMENT OF GASTRIC OUTLET OBSTRUCTION: A SINGLE CENTRE EXPERIENCE. Endoscopy 2021; 53: S47.

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Artikel online veröffentlicht:
19. März 2021