Aims There are various modalities of management of gastric outlet obstruction (GOO) namely
endoscopic enteral stenting, surgical bypass or placement of a venting gastrostomy
tube. Endoscopic ultrasound guided gastrojejunostomy (EUS-GJ) via placement of a lumen
apposing metal stent has recently emerged as a viable and effective method of managing
GOO. We aimed to describe the procedural characteristics, technical and clinical outcomes
in patients who underwent EUS-GJ at our institution.
Methods A prospectively collected database of consecutive EUS-GJ procedures from August 2018
to October 2020 at our institution was reviewed retrospectively. All procedures were
performed by two expert pancreatobiliary endoscopists. Recorded variables included
patient demographics, technical success, clinical success, adverse events, 30-day
all cause mortality and follow-up duration.
Results Sixteen patients (9 males) with a mean age of 64.5 years old (range 48 – 80 years
old) were identified. Malignancy was the predominant aetiology of GOO in our patient
cohort (81.3 %, n=13). The technical success rate (defined as fluoroscopic and endoscopic
confirmation of adequate stent deployment and positioning) was 93.8 % (n=15), in whom
the clinical success rate (defined as toleration of at least liquid diet without vomiting
before discharge) was 100 %. In the solitary case of technical failure, dislodgement
occurred during balloon dilatation of the stent, the defect was endoscopically closed
with clips and a duodenal stent was placed. The patient did not experience any adverse
consequences post-procedure. Nine patients who required intravenous parenteral nutrition
pre-procedure were successfully weaned off following EUS-GJ. The median follow-up
was 109 days (range 5 – 383 days). No adverse events were encountered. One patient
required re-intervention at day 70. 30-day all cause mortality was 6.3 % (n=1) and
the death was due to malignant disease progression.
Conclusions EUS-GJ is an effective and safe procedure for the management of GOO. It should be
considered in appropriately selected patients if there is available expertise.
Citation: On W, Huggett MT, Paranandi B. OP111 EUS GUIDED GASTROJEJUNOSTOMY FOR THE MANAGEMENT
OF GASTRIC OUTLET OBSTRUCTION: A SINGLE CENTRE EXPERIENCE. Endoscopy 2021; 53: S47.
