Endosc Int Open 2016; 04(03): E276-E281
DOI: 10.1055/s-0042-101789
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic ultrasound-guided gastrojejunostomy with a lumen-apposing metal stent: a multicenter, international experience

Amy Tyberg
1  Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, New York, USA
,
Manuel Perez-Miranda
2  Gastroenterology Department, Hospital Universitario Rio Hortega, Valladolid, Spain
,
Ramon Sanchez-Ocaña
2  Gastroenterology Department, Hospital Universitario Rio Hortega, Valladolid, Spain
,
Irene Peñas
2  Gastroenterology Department, Hospital Universitario Rio Hortega, Valladolid, Spain
,
Carlos de la Serna
2  Gastroenterology Department, Hospital Universitario Rio Hortega, Valladolid, Spain
,
Janak Shah
3  Paul May and Frank Stein Interventional Endoscopy Center, California Pacific Medical Center, San Francisco, California, USA
,
Kenneth Binmoeller
3  Paul May and Frank Stein Interventional Endoscopy Center, California Pacific Medical Center, San Francisco, California, USA
,
Monica Gaidhane
1  Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, New York, USA
,
Ian Grimm
4  Division of Gastroenterology and Hepatology, UNC School of Medicine, Chapel Hill, North Carolina, USA
,
Todd Baron
4  Division of Gastroenterology and Hepatology, UNC School of Medicine, Chapel Hill, North Carolina, USA
,
Michel Kahaleh
1  Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, New York, USA
› Author Affiliations
Further Information

Publication History

submitted 17 November 2015

accepted after revision 15 December 2015

Publication Date:
18 March 2016 (online)

  

Background: Surgical gastrojejunostomy and enteral self-expanding metal stents are efficacious for the management of gastric outlet obstruction but limited by high complication rates and short-term efficacy. Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) is a novel alternative option.

Patients and methods: Patients who underwent EUS-GJ between March 2014 and September 2015 as part of a prospective multicenter registry at four academic centers in two countries were included. Technical success was defined as successful placement of a gastrojejunal lumen-apposing metal stent. Clinical success was defined as the ability of the patient to tolerate an oral diet. Post-procedural adverse events were recorded.

Results: The study included 26 patients, of whom 11 (42 %) were male. Technical success was achieved in 24 patients (92 %). Clinical success was achieved in 22 patients (85 %). Of the 4 patients in whom clinical success was not achieved, 2 had persistent nausea and vomiting despite a patent EUS-GJ and required enteral feeding for nutrition, 1 died before the initiation of an oral diet, and 1 underwent surgery for suspected perforation. Adverse events, including peritonitis, bleeding, and surgery, occurred in 3 patients (11.5 %).

Conclusion: EUS-GJ is an emerging procedure that has efficacy and safety comparable with those of current therapies and should hold a place as a new minimally invasive option for patients with gastric outlet obstruction.

Clinical trial identification number: NCT01522573