Gastric outlet obstruction (GOO) can be caused by periampullary malignancies and often leads to a reduction in a patient's quality of life. Recently, endoscopic ultrasonography-guided gastroenterostomy (EUS-GE) using a lumen-apposing self-expandable metal stent (LAMS) has been developed as a minimally invasive and durable endoscopic treatment for GOO. EUS-GE has the advantage of being minimally invasive as an endoscopic procedure and EUS-GE could provide long-lasting effects with lower recurrence rates. Moreover, a recent study suggests that EUS-GE has similar technical and clinical success rates compared to laparoscopic gastroenterostomy. Interestingly, EUS- intervention seems to reduce the length of stay and incidence of AEs, suggesting possible advantages compared to surgery.
In our prospective study including 139 patients, technical and clinical success was achieved in 136 patients (97.8%) and 129 (92.8%), respectively. The mean change in the gastric outlet obstruction scoring system (GOOSS) after EUS-GE was 2.2. During a mean follow-up of 131 days, 10 patients (7.4%) need reintervention. Adverse events, including stent mal-displacement, bleeding and migration, occurred in 16 patients (13.1%). EUS-GE is an emerging and minimally invasive procedure that has efficacy and safety comparable with those of current therapies for the management of malignant GOO. |
