EUS-guided gastroenterostomy with a lumen apposing self-expandable metallic stent relieves gastric outlet obstruction – a Scandinavian case series

Havre, Roald Flesland; Dai, Chengbo; Roug, Stine; Novovic, Srdan; Schmidt, Palle Nordblad; Feldager, Erik; Karstensen, John Gásdal; Pham, Khanh Do-Cong

doi:10.1080/00365521.2021.1925338

Cited by 7 publications

(8 citation statements)

References 27 publications

(37 reference statements)

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“…Of those, 15 reported DGE [14,[23][24][25][26][27][28][29][30][31][32][33][34][35][36], and six reported BTGE [12,14,[37][38][39][40]. The total amount of patients was 863-718 in DGE and 145 in BTGE (27 in BAGE and 118 in EPASS), respectively.…”

Section: Resultsmentioning

confidence: 99%

“…We also excluded those that did not specify the techniques used or if there were mixed EUS-GE techniques in the pool of patients. A total of 20 studies fulfilled our inclusion criteria: 12 case series and eight comparative studies [12,14,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40].…”

Section: Resultsmentioning

confidence: 99%

“…All studies reported clinical success [12,14,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. Clinical success rates were 90.6% for DGE and 88.9% for BTGE (Table 6) with an RD of -0.007 (95% CI -0.06 to 0.046 I2=0% p=0.798) without statistical difference between the groups (Figure 3).…”

Section: Clinical Successmentioning

confidence: 95%

“…Nineteen studies reported severe AEs [12,14,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. The rate was 3.4% and 8.2% for DGE and BTGE (Table 6), respectively.…”

Section: Severe Adverse Eventsmentioning

confidence: 99%

“…All studies [12,14,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] were included in this analysis. The technical success was 94.8% in the direct puncture group and 93.6% in the balloon-assisted group (Table 6), with an RD of -0.012 (95% CI -0.055 to 0.031 I2= 0% p=0.585) without statistical difference between the groups (Figure 2).…”

Section: Technical Successmentioning

confidence: 99%

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Endoscopic Ultrasound-Guided Gastroenterostomy for the Palliation of Gastric Outlet Obstruction (GOO): A Systematic Review and Meta-analysis of the Different Techniques

Ribas¹,

Proença²,

Júnior³

et al. 2022

Cureus

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Introduction: Gastric outlet obstruction (GOO) is usually associated with a poor prognosis and a significant decrease in a patient's quality of life. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using lumen-apposing metal stents (LAMS) has emerged as a safe and effective palliation procedure for GOO in patients that are unfit for surgery. Without an exclusive gold-standard technique for EUS-GE, we aimed to compare the currently available ones in this systematic review and meta-analysis, the first on this subspecialty.Methods: A comprehensive search from multiple electronic databases was performed. The search had a particular emphasis on the techniques used in performing EUS-GE. We identified all the studies in which EUS-GE was performed as palliation for GOO from its inception to the current date. The outcomes analyzed were the following: technical and clinical success, total and severe adverse events (AEs), procedure duration, and length of hospital stay (LOHS).Results: Twenty studies involving 863 patients were the basis of this statistical analysis. Patients underwent the following techniques: direct gastroenterostomy (DGE) (n=718), balloon-assisted gastroenterostomy (BAGE) (n=27), and endoscopic ultrasound (EUS)-guided double-balloon-occluded gastrojejunostomy bypass (n=118). In comparison to balloon-assisted techniques, DGE had a lower rate of AEs, -0.121 (95% CI -0.191 to -0.051 p=0.001); and LOHS for the DGE group, -2.684 (95% CI -1.031 to -4.337 p=0.001). The other analyzed outcomes presented no statistically significant differences. On a sub-analysis, BAGE showed a lower rate of AEs than EUS-guided double-balloon-occluded gastrojejunostomy bypass, -0.196 (95% CI -0.061 to -0.331 p=0.004).Conclusions: EUS-GE is a safe and effective procedure for palliating GOO. When correctly administered, any of the analyzed techniques may be used to palliate GOO with similar technical and clinical outcomes. DGE had significantly lower rates of AEs and LOHS, which can be inferred as a safer procedure. These results should be interpreted cautiously due to the limited few studies that are available and accessible. Therefore, further well-designed, randomized clinical studies on the topic are warranted to compare the different techniques from more sources.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Clinical Successmentioning

confidence: 95%

“…Nineteen studies reported severe AEs [12,14,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. The rate was 3.4% and 8.2% for DGE and BTGE (Table 6), respectively.…”

Section: Severe Adverse Eventsmentioning

confidence: 99%

Section: Technical Successmentioning

confidence: 99%

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Endoscopic Ultrasound-Guided Gastroenterostomy for the Palliation of Gastric Outlet Obstruction (GOO): A Systematic Review and Meta-analysis of the Different Techniques

Ribas¹,

Proença²,

Júnior³

et al. 2022

Cureus

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Adverse events with endoscopic ultrasound‐guided gastroenterostomy for gastric outlet obstruction—A systematic review and meta‐analysis

Giri,

Harindranath,

Mohan

et al. 2024

UEG Journal

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BackgroundThe technical and clinical effectiveness of endoscopic ultrasonography (EUS)‐guided gastroenterostomy (GE) has been reported by several meta‐analyses, but few of them have addressed the adverse events (AE). The goal of the current meta‐analysis was to analyze the AEs associated with various types of EUS‐GE.MethodsAll relevant studies reporting the AEs with EUS‐GE were searched from 2000 to 31st March 2023 in MEDLINE, Embase, and Scopus. The event rates were pooled using a random effects model.ResultsA total of 36 studies (n = 1846) were included in the meta‐analysis. The present meta‐analysis reports a pooled technical success rate of 96.9% (95.9–98.0; I2 = 29.3%) with a pooled clinical success rate of 90.6% (88.5–92.7; I2 = 60.9%). The pooled incidence of overall AEs with EUS‐GE was 13.0% (10.3–15.7; I2 = 69.7%), with the commonest being maldeployment of the stent, seen in 4.6% (3.2–6.0; I2 = 50.6%). The pooled incidences of serious AE and procedure‐related mortality were 1.2% (0.7–1.8; I2 = 1.9%) and 0.3% (0.0–0.7; I2 = 0.0%), respectively. Subgroup analysis of studies using only the free‐hand technique showed a significantly lower overall AE and maldeployment but not serious AE and other individual AEs. The pooled incidences of delayed stent migration and stent occlusion were 0.5% (0.0–1.1; I2 = 0.0%) and 0.8% (0.2–1.3; I2 = 0.0%), respectively.ConclusionDespite a technical and clinical success rate of >90%, AEs are seen in around one‐seventh of the cases of EUS‐GE, maldeployment being the commonest. However, the pooled incidence of serious AE and mortality remains low, which is reassuring.

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EUS-guided gastroenterostomy using a novel through-the-scope exchangeable dual-balloon enteroclysis catheter: a potentially secure and scalable approach

Chen,

Menard,

Khashab

et al. 2023

VideoGIE

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EUS-guided gastroenterostomy with a lumen apposing self-expandable metallic stent relieves gastric outlet obstruction – a Scandinavian case series

Abstract: 2021): EUS-guided gastroenterostomy with a lumen apposing self-expandable metallic stent relieves gastric outlet obstruction -a Scandinavian case series,

Cited by 7 publications

References 27 publications

Endoscopic Ultrasound-Guided Gastroenterostomy for the Palliation of Gastric Outlet Obstruction (GOO): A Systematic Review and Meta-analysis of the Different Techniques

Endoscopic Ultrasound-Guided Gastroenterostomy for the Palliation of Gastric Outlet Obstruction (GOO): A Systematic Review and Meta-analysis of the Different Techniques

Adverse events with endoscopic ultrasound‐guided gastroenterostomy for gastric outlet obstruction—A systematic review and meta‐analysis

EUS-guided gastroenterostomy using a novel through-the-scope exchangeable dual-balloon enteroclysis catheter: a potentially secure and scalable approach

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