Long-Term Clinical Success of Endoscopic Ultrasound-Guided Gastroenterostomy in Benign Gastric Outlet Obstruction.

IF 4.7

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society Pub Date : 2025-07-17 DOI:10.1111/den.15087

Antonio Martinez-Ortega, F Javier García-Alonso, Natalia Marcos Carrasco, Amaia Arrubla Gamboa, Lucía Guilabert, Carlos Abril García, Félix Téllez-Avila, José Carlos Subtil Íñigo, Belén Martínez-Moreno, Marina Cobreros Del Caz, Juan J Vila, Vicente Sanchiz Soler, José R Aparicio Tormo, Alejandro Repiso Ortega, José Miguel Esteban, Antonio Velasco-Guardado, Ferrán Gónzalez-Huix, Carlos de la Serna Higuera, Manuel Perez-Miranda

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Abstract

Background and aims: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is an established treatment for malignant gastric outlet obstruction (GOO). Data on EUS-GE for benign GOO (bGOO) are limited. This study aimed to evaluate long-term clinical outcomes of EUS-GE in bGOO.

Methods: Retrospective study on consecutive patients who underwent EUS-GE for bGOO using lumen apposing metal stents (LAMS) at 9 Spanish centers. The primary outcome was the ability to regain and maintain oral feeding. Secondary outcomes included technical success, immediate clinical success, LAMS dysfunction, and adverse event rates.

Results: Sixty-two patients (75.8% male) with a median age of 65 years (56.9-74) were included. Most cases of bGOO were related to chronic (35.5%) or acute (24.2%) pancreatitis. Technical success was achieved in 61 (98.4%), and immediate clinical success in 57 (91.9%) patients. Among patients reaching immediate clinical success, the median LAMS indwell time was 505 (201-848) days. LAMS dysfunction developed in 7 (12.3%) patients after a median of 1200 (IQR: 94-1568) days. Oral feeding at 24 months was maintained in 85.3% patients overall and in 93.6% patients among those with immediate clinical success. Seven adverse events, including a fatal aspiration pneumonia and a fatal delayed bleeding, occurred in 6 (9.7%) patients.

Conclusions: EUS-GE has a high immediate clinical success rate in patients with bGOO and a low risk of stent dysfunction.

Trial registration: Promotor center identification number: PI-24-448-H.

查看原文本刊更多论文

超声内镜引导下胃造口术治疗良性胃出口梗阻的长期临床成功。

背景与目的：超声内镜引导下的胃肠造口术（EUS-GE）是治疗恶性胃出口梗阻（GOO）的常用方法。EUS-GE诊断良性粘胶瘤（bGOO）的数据有限。本研究旨在评估EUS-GE治疗bGOO的长期临床结果。方法：回顾性研究西班牙9个中心连续使用腔内金属支架（LAMS）行EUS-GE治疗bGOO的患者。主要结果是恢复和维持口服喂养的能力。次要结局包括技术成功、即时临床成功、LAMS功能障碍和不良事件发生率。结果：纳入62例患者，男性75.8%，中位年龄65岁（56.9-74岁）。大多数bGOO病例与慢性（35.5%）或急性（24.2%）胰腺炎有关。技术成功61例（98.4%），即刻临床成功57例（91.9%）。在立即获得临床成功的患者中，LAMS留置时间中位数为505（201-848）天。7例（12.3%）患者在中位1200 （IQR: 94-1568）天后出现LAMS功能障碍。总体而言，85.3%的患者在24个月时维持口服喂养，在立即取得临床成功的患者中，这一比例为93.6%。6例（9.7%）患者发生了7个不良事件，包括致命性吸入性肺炎和致命性延迟性出血。结论：EUS-GE治疗bGOO患者临床即刻成功率高，支架功能障碍风险低。试验注册：启动子中心识别号：PI-24-448-H。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society

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