EUS-guided gastroenterostomy for afferent loop syndrome treatment stent

Benallal, Dina Chaaro; Hoibian, Solène; Caillol, Fabrice; Bories, Erwan; Presenti, Christian; Ratone, JP; Giovannini, Marc

doi:10.4103/eus.eus_41_17

Cited by 13 publications

(14 citation statements)

References 5 publications

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“…Table 3 summarizes previous reports concerning EUS-GE for ALS. 9,20,[23][24][25][26][27][28][29][30][31] The reports were identified from the PubMed database for English-language studies using the following keywords: "afferent loop syndrome" and "endo-…”

Section: Clinical Outcomes Of Eus-ge In Patients With Alsmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop Syndrome

et al. 2021

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Afferent loop syndrome (ALS) is a mechanical obstruction of the afferent limbs after gastrectomy with gastrojejunostomy reconstruction. Patients with cancer recurrence require immediate and less invasive treatment because of their poor condition. Percutaneous transhepatic/transluminal drainage (PTD) and endoscopic enteral stenting offer reasonable palliative treatment for malignant ALS but are not fully satisfactory in terms of patient quality of life (QoL) and stent patency. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using a lumen-apposing metal stent may address these shortcomings. Clinical data from 11 reports showed that all patients who had undergone EUS-GE had positive technical and clinical outcomes. The adverse event rate was 11.4%, including only mild or moderate abdominal pain, with no severe adverse events. Indirect comparative studies indicated that patients who had undergone EUS-GE had a significantly superior QoL, a higher clinical success rate, and a lower reintervention rate than those who had undergone PTD or endoscopic enteral stenting. Although the evidence is limited, EUS-GE may be considered as a first-line treatment for malignant ALS because it has better clinical outcomes than other less invasive treatments, such as PTD or endoscopic enteral stenting. Further prospective randomized control trials are necessary to establish EUS-GE as a standard treatment for ALS.

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Section: Clinical Outcomes Of Eus-ge In Patients With Alsmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop Syndrome

et al. 2021

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“…Nonetheless, even if an ideal stent is available, EUS-GE is still a technically demanding procedure because access to the duodenum and jejunum is difficult and unpredictable. [43] Moreover, given that air insufflation, which can seriously affect the accuracy of ultrasound images, precludes ultrasound imaging, safe puncture into the small bowel is not guaranteed. To overcome this problem, water-filling luminal techniques have been used.…”

Section: Techniques In Endoscopic Ultrasound-guided Gastroenterostomymentioning

confidence: 99%

“…Several investigators have now developed unique and novel LAMS-based techniques for EUS-GE founded on the approaches above. [2,43,45,46]…”

Section: Techniques In Endoscopic Ultrasound-guided Gastroenterostomymentioning

confidence: 99%

Endoscopic Ultrasound-guided Gastroenterostomy: A Promising Alternative to Surgery

Wang

Xiang

Wang

et al. 2019

Journal of Translational Internal Medicine

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Recently, with the advancement of techniques, endoscopic ultrasound-guided therapies have shown distinct advantages, especially in relieving benign and malignant gastric outlet obstruction (GOO), as well as in postoperative pancreaticobiliary diseases. Herein, we present five currently used approaches in endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using lumenapposing biflanged metal stents (LAMS), along with several examples of LAMS-based EUS treatment of pancreaticobiliary diseases. Compared with traditional treatment methods, EUS-guided procedures have – to some degree – shown higher success rates, both technical and clinical. Moreover, EUS-guided therapies reduce the risk of multiple surgical adverse events, including delayed gastric emptying, prolonged hospital stay, increased costs, and delay in cancer treatment. Particularly in terms of postoperative pancreaticobiliary diseases, EUS-guided therapy has assumed an essential role as a treatment option in cases where traditional methods are difficult to perform. Nevertheless, EUS-guided gastrointestinal procedures are still relatively new, with some clinical failures, and additional prospective clinical trials are warranted.

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“…1,2 Surgical gastrojejunostomy and endoscopic stenting are traditional treatment options, but these two treatments have limitations. Recently, endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has emerged as an alternative option for GOO [3][4][5] that is minimally invasive and provides an effective outcome. However, EUS-GE is a technically challenging procedure.…”

Section: Introductionmentioning

confidence: 99%

The region ahead of the pancreas is a suitable place for performing endoscopic ultrasound-guided gastroenterostomy: from clinical data to swine trial

Wang

Gao

et al. 2020

Preprint

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Background and Aims: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a minimally invasive treatment for gastric outlet obstruction that results in a low incidence of recurrence. This is the first study to investigate a suitable position for performing EUS-GE. Methods: We reviewed the clinical data from 20 upper gastrointestinal examinations and 20 computed tomography scans of the abdomen and hypothesized that the posterior wall of the stomach was a suitable place to perform EUS-GE. We verified this hypothesis by performing an animal study using 5 swine. Results: All retrievable anchor assisted EUS-GE were successfully performed at the intestinal region that was proximal to the head of the pancreas. The mean procedure time of EUS-GE was 28.4 ± 3.85 minutes (range of 22–32 minutes). There were no adverse events, such as bleeding. Necropsy of the animals showed that all of the stents were in the correct position. The mean distance between the site of gastroenterostomy and pylorus was 34.6 ± 3.58 cm (range of 30–38 cm). Conclusions: The intestinal region that was proximal to the head of the pancreas was a suitable place for performing endoscopic ultrasound-guided gastroenterostomy. The suitability of this location should be confirmed by further animal and clinical studies.

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EUS-guided gastroenterostomy for afferent loop syndrome treatment stent

Cited by 13 publications

References 5 publications

Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop Syndrome

Endoscopic Ultrasound-Guided Gastroenterostomy for Afferent Loop Syndrome

Endoscopic Ultrasound-guided Gastroenterostomy: A Promising Alternative to Surgery

The region ahead of the pancreas is a suitable place for performing endoscopic ultrasound-guided gastroenterostomy: from clinical data to swine trial

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