Modified endoscopic ultrasound-guided double-balloon-occluded gastroenterostomy bypass (M-EPASS): a pilot study

Amanda Marino; Ali Bessissow; Corey Miller; David Valenti; Louis Boucher; Prosanto Chaudhury; Jeffrey Barkun; Nauzer Forbes; Mouen A. Khashab; Myriam Martel; Yen-I Chen

doi:10.1055/a-1392-4546

Endoscopy, Inhaltsverzeichnis

Endoscopy 2022; 54(02): 170-172
DOI: 10.1055/a-1392-4546

Innovations and brief communications

Modified endoscopic ultrasound-guided double-balloon-occluded gastroenterostomy bypass (M-EPASS): a pilot study

Amanda Marino

¹Division of Gastroenterology and Hepatology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

,

Ali Bessissow

²Division of Interventional Radiology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

,

Corey Miller

³Division of Gastroenterology and Hepatology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada

,

David Valenti

²Division of Interventional Radiology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

,

Louis Boucher

²Division of Interventional Radiology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

,

Prosanto Chaudhury

⁴Department of Surgery, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

,

Jeffrey Barkun

⁴Department of Surgery, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

,

Nauzer Forbes

⁵Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada

,

Mouen A. Khashab

⁶Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, Maryland, USA

,

Myriam Martel

¹Division of Gastroenterology and Hepatology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

,

Yen-I Chen

¹Division of Gastroenterology and Hepatology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada

› Institutsangaben

Abstract

Introduction We recently developed a double-balloon device, using widely available existing technology, to facilitate endoscopic ultrasound-guided gastroenterostomy (EUS-GE). Our aim is to assess the feasibility of this modified approach to EUS-guided double-balloon-occluded gastroenterostomy bypass (M-EPASS).

Methods This was a single-center retrospective study of consecutive patients undergoing M-EPASS from January 2019 to August 2020. The double-balloon device consists of two vascular balloons that optimize the distension of a targeted small-bowel segment for EUS-guided stent insertion. The primary end point was the rate of technical success.

Results 11 patients (45 % women; mean [standard deviation (SD)] age 64.9 [8.6]) with malignant gastric outlet obstruction were included. Technical and clinical success (ability to tolerate an oral diet) were achieved in 91 % (10/11) and 80 % (8/10) of patients, respectively. There was one adverse event (9 %) due to stent migration. Two patients (18 %) required re-intervention for stent obstruction secondary to food impaction. The mean (SD) time to a low residue diet was 3.5 (2.4) days.

Conclusion M-EPASS appears to facilitate the technique of EUS-GE, potentially enhancing its safety and clinical adoption. Larger studies are needed to validate this innovative approach to gastric outlet obstruction.

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Referenzen

References
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