Endoscopic Ultrasound-Guided Gastroenteric Anastomosis: A French Center Experience

Aims Endoscopic ultrasound-guided gastroenteric anastomosis (EUS-GEA) is a minimally invasive alternative to surgery in the treatment gastric outlet obstruction. We aim to present a single center cohort highlighting the rate of benign indications and management of stent dislodgement.

Methods We reviewed, from a prospective database, all EUS-GEA performed in a tertiary care French hospital, from January 2014 to November 2020. Procedures were all performed under EUS and fluoroscopy control, for jejunal loop identification and LAMS (lumen apposition metal stent) deployment under general anesthesia.

Results A total of 22 EUS-GEA were performed in 20 patients (59.1 % men) with a median age of 66.5 years old (IQ: 50-73). 13 (59.1 %) were performed for malignant indications and 9/22 (41 %) with a 15 mm Axios LAMS. The technical and clinical success rates were respectively 87 % and 77 %, with a perprocedural adverse event rate of 27.3 % (none was fatal). 83.3 % of them (5/6) were due to LAMS misdeployment in the intraperitoneal cavity. Among them, 3/5 (60 %) were successfully treated by salvage second Axios insertion with NOTES procedures, for the others, the perforation was successively closed by an OVESCO clip. The technical failure causes were gastric portal hypertension precluding a good acoustic window for jejunal loop puncture (n = 2) and extensive gastric fibrosis (n = 1; caustic fibrosis). Hospital median stay duration was 8 (IQ:(5.3-15.8) days. No death related to the procedure occurred.

Conclusions EUS- GJA seems to be ready for prime time since benign indications reached a 41 % rate and salvage therapy is efficient in case of LAS stent dislodgement.

Citation Ouazzani S, Becar A, Gasmi M et al. eP444 ENDOSCOPIC ULTRASOUND-GUIDED GASTROENTERIC ANASTOMOSIS: A FRENCH CENTER EXPERIENCE. Endoscopy 2021; 53: S243.

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Artikel online veröffentlicht:
19. März 2021