Midterm Evaluation of EUS-guided Gastroenterostomy for Gastric Outlet Obstruction: An International Collaborative Study

• Published in: Journal of clinical gastroenterology
• Main Authors: Canakis, Andrew, Gaidhane, Monica, Shahid, Haroon M, Tyberg, Amy, Miller, Dillon C, Bareket, Romy, Chen, Conan, Karagyozov, Petko, Sarkar, Avik, Widmer, Jessica L, Artifon, Everson L, Kedia, Prashant, Chowdhury, Salil, Chalikonda, Divya M, Dioguardi, Vincent, Loren, David E, Kowalski, Thomas E, Schlachterman, Alexander, Kumar, Anand, Chiang, Austin, Cunto, Domenica, Robles-Medranda, Carolos, Kahaleh, Michel
• Format: Journal Article
• Language: English
• Published: United States 13.03.2025
• ISSN: 1539-2031
• DOI: 10.1097/MCG.0000000000002174

EUS-guided gastroenterostomy (EUS-GE) is a minimally invasive therapy for the management of gastric outlet obstruction (GOO). EUS-GE has demonstrated excellent short-term efficacy without the risks of surgical bypass. However, there is limited data on follow-up outcomes. In this study, we collected 6-month follow-up data on patients who underwent EUS-GE for benign and malignant etiologies, to aim to show the shift in paradigm in their management algorithm. This was a retrospective multicenter study across 7 international centers of consecutive patients undergoing EUS-GE over a 4-year period who were entered in a dedicated registry. Demographic characteristics, procedure-related information, and follow-up data were collected. Primary outcome was the 6-month data on clinical resolution of GOO. Ninety-one patients were included (71 malignant and 20 benign cases). Technical success was 99% due to high expertise and volume. Clinical success at 48 hours was 97% (88/90) with an average procedure time of 47 minutes and length of stay of 5.86 days. At 3 months, 87 (95.6%) patients had achieved clinical resolution. At 6 months, 48 (53%) subjects were alive, 40 (44%) were deceased, 3 were lost to follow-up (3.3%) and 1 (1%) had a recurrence of GOO. Clinical success at 6 months follow-up was 98% (47/48). The majority of patients with GOO who undergo EUS-GE showed clinical resolution at 6-month follow-up. Patients with malignant etiology are appropriately palliated during their life span. Further prospective studies are necessary to obtain long-term data regarding EUS-GE for benign etiologies.