Clinical endoscopy · 2026
Comparative retrospective outcomes of endoscopic ultrasound-guided gastroenterostomy in patients with gastric outlet obstruction and post-surgical anatomy.
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Bronswijk Michiel, Clerick Jan, Vanella Giuseppe, Samanta Jayanta, van Wanrooij Roy L J, Van der Merwe Schalk
Аннотация
BACKGROUND: Data on endoscopic ultrasound (EUS)-guided gastroenterostomy (EUS-GE) are mainly derived from patients with naïve anatomy. This study aimed to evaluate the outcomes of EUS-GE in patients with post-surgical anatomy and compare these findings with those from a cohort of patients with naïve anatomy.
METHODS: A retrospective tertiary center analysis was performed of consecutive EUS-GE procedures. The wireless-EUS-GE-simplified technique (WEST) was employed for EUS-GE. Clinical success was defined as achieving a postprocedural gastric outlet obstruction scoring system score of ≥2.
RESULTS: Overall, 10 patients with post-surgical anatomy and 63 sequential historical controls with naïve anatomy were included from the same time frame (2019-2022). Surgery consisted predominantly of Whipple resection (n=3) or partial gastrectomy (n=2). Clinical success was achieved in 90.0% and 90.5% of patients in the post-surgical and naïve anatomy groups, respectively (p=1.000). Technical success (90.0% vs. 96.8%, p=0.362), median hospital stay (8 vs. 6 days, p=0.397), adverse event rate (10.0% vs. 7.9%, p=1.000), and median follow-up duration (186 vs. 136 days, p=0.303) were comparable between the two groups. However, the median procedure duration was significantly longer in the post-surgical anatomy group compared to that in the naïve group (61 vs. 45 minutes, p=0.037).
CONCLUSIONS: Although increased technical complexity and a limited sample size should be considered, our comparative data suggest that EUS-GE was equally effective in patients with post-surgical anatomy.
METHODS: A retrospective tertiary center analysis was performed of consecutive EUS-GE procedures. The wireless-EUS-GE-simplified technique (WEST) was employed for EUS-GE. Clinical success was defined as achieving a postprocedural gastric outlet obstruction scoring system score of ≥2.
RESULTS: Overall, 10 patients with post-surgical anatomy and 63 sequential historical controls with naïve anatomy were included from the same time frame (2019-2022). Surgery consisted predominantly of Whipple resection (n=3) or partial gastrectomy (n=2). Clinical success was achieved in 90.0% and 90.5% of patients in the post-surgical and naïve anatomy groups, respectively (p=1.000). Technical success (90.0% vs. 96.8%, p=0.362), median hospital stay (8 vs. 6 days, p=0.397), adverse event rate (10.0% vs. 7.9%, p=1.000), and median follow-up duration (186 vs. 136 days, p=0.303) were comparable between the two groups. However, the median procedure duration was significantly longer in the post-surgical anatomy group compared to that in the naïve group (61 vs. 45 minutes, p=0.037).
CONCLUSIONS: Although increased technical complexity and a limited sample size should be considered, our comparative data suggest that EUS-GE was equally effective in patients with post-surgical anatomy.