期刊
JOURNAL OF CLINICAL GASTROENTEROLOGY
卷 51, 期 10, 页码 896-899出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCG.0000000000000887
关键词
gastrojejunostomy; gastric outlet obstruction; EUS; EUS-GJ; GOO; LAMS
资金
- Boston Scientific
- Fujinon
- EMcison
- Xlumena Inc.
- W.L. Gore
- MaunaKea
- Apollo Endosurgery
- Cook Endoscopy
- ASPIRE Bariatrics
- GI Dynamics
- NinePoint Medical
- Merit Medical
- Olympus
- MI Tech
Introduction: Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) with placement of a lumen-apposing metal stent is a minimally invasive and efficacious procedure for gastric outlet obstruction (GOO) patients not amenable to surgery. Laparoscopic gastrojejunostomy (Lap-GJ) has traditionally been the standard of care. No direct comparison between EUS-GJ and Lap-GJ has been described. Our aim was to compare the clinical outcomes, success rate, and adverse events (AE) of EUS-GJ with Lap-GJ. Methods: Patients with GOO from 4 academic centers in 3 countries were included. Technical success was defined as successful creation of a gastrojejunostomy. Clinical success was defined as the ability to tolerate a diet postprocedure. Results: Data were collected on 54 patients. A total of 25 patients underwent EUS-GJ (male n=11, mean age 63.9 y) and 29 patients underwent Lap-GJ (male n=22, mean age 75.8 y). Technical success was achieved in 29 (100%) Lap-GJ group patients and 23 (88%) in the EUS-GJ group (P=0.11). AEs occurred in 41% (n=12) of patients in the Lap-GJ group and 12% (n=3) in the EUS-GJ group (P=0.0386). According to the Clavien-Dindo Classification, the Lap-GJ group AEs were grade I (n=4), grade II (n=5), grade III (n=2), and grade V (n=1); the EUS-GJ AEs were grade II (n=2) and grade V (n=1). Conclusions: Although the EUS-GJ group contained more complex patients, efficacy was similar between the groups. AEs were significantly lower in the EUS-GJ group. EUS-GJ is a safe and efficacious, minimally invasive option for patients with GOO.
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