Clinical Review of EUS-guided Gastroenterostomy (EUS-GE)

Ana Y. Carbajo, Michel Kahaleh, Amy Tyberg

Research output: Contribution to journalReview article

2 Scopus citations

Abstract

Gastric outlet obstruction (GOO) refers to mechanical obstruction of the distal stomach or proximal duodenum and it is associated with a significant decrease in quality of life. Surgical gastrojejunostomy and self-expandable metal stents were the traditional treatment for GOO. Recently, endoscopic ultrasound guided gastroenterostomy (EUS-GE) has emerged as a third therapeutic option for patients with GOO. Most EUS-GE techniques utilize the placement of a lumen-apposing metal stent under echoendoscopy but differ in the method of localizing the jejunal loop prior to EUS puncture. Data supporting EUS-GE have been promising. Case series including 10 or more cases showed the technical success rate to be approximately 90%. Clinical success is achieved in approximately 85-90% and a less than 18% risk of adverse events is reported. EUS-GE was associated with a lower recurrence of GOO and need for re-intervention when compared to enteral stenting. In addition, EUS-GE shows significantly fewer adverse events compared with surgical gastrojejunostomy. In conclusion, EUS-GE provides symptom relief without the risks of surgical intervention and the limited patency of enteral SEMS placement. EUS-GE is an exciting new option in the management of GOO. Despite the excellent results, randomized studies comparing these different modalities of treatment for GOO are needed before EUS-GE can be accepted as standard of care.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalJournal of Clinical Gastroenterology
Volume54
Issue number1
DOIs
StatePublished - Jan 1 2020
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Keywords

  • EUS-guided gastrojejunostomy
  • gastric outlet obstruction
  • lumen-apposing metal stent
  • therapeutic endoscopic ultrasound

Fingerprint Dive into the research topics of 'Clinical Review of EUS-guided Gastroenterostomy (EUS-GE)'. Together they form a unique fingerprint.

  • Cite this