Comparative analysis of gastric emptying between patients undergoing EUS-guided gastroenterostomy and enteral stent placement: Pilot analysis.

Abstract

Background and study aims: Previous studies show that endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is better than enteral stents (ESs) in terms of clinical success and need for reintervention in the long term. Gastric atony and stent placement across a tumor can lead to poor gastric emptying after ES placement. We aimed to compare gastric emptying across ES and EUS-GE to assess the benefit of EUS-GE over ES in the short-term.

Patients and methods: In this pilot study, patients who underwent ES or EUS-GE for palliation of gastric outlet obstruction were included. A gastric emptying study was performed 2 weeks after the procedure after consumption of a semisolid test-meal (Indian porridge) labelled with Tc-Sulphur. The primary outcome was gastric emptying t1/2 between ES and EUS-GE.

Results: Forty patients were included in this study (21 ES, 19 EUS-GE; mean age 54 years, 27 males). EUS-GE had a faster emptying t1/2 as compared with ES (72 mins vs 118 mins) ( P = 0.02). Abnormal emptying was seen in fewer patients undergoing EUS-GE (5.3% vs 47.6% [ES]; P = 0.004). Clinical success at 2 weeks and reintervention at 6 months was no different.

Conclusions: EUS-GE was associated with better gastric emptying compared with ES, suggesting a benefit that may translate into clinical benefit even in the short term.