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

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.