Amin Sunil, Sethi Amrita
Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, 161 Fort Washington Avenue, 852A, New York, NY 10032, USA.
Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, 161 Fort Washington Avenue, 852A, New York, NY 10032, USA.
Gastrointest Endosc Clin N Am. 2017 Oct;27(4):707-713. doi: 10.1016/j.giec.2017.06.009.
Gastric outlet obstruction is a common complication of advanced upper gastrointestinal and pancreatic malignancies. Endoscopic ultrasound (EUS)-guided gastrojejunostomy is a new option that may provide a more durable solution than enteral stenting with shorter recovery time and less cost than surgical gastrojejunostomy. Techniques to perform this procedure include direct EUS-guided puncture and balloon-assisted and free-hand methods. Use of cautery-tipped lumen-apposing metal stent results in higher rates of technical success and shorter procedure times. Prospective studies are needed to compare EUS-gastrojejunostomy with enteral stenting and surgical gastrojejusntomy, and to clarify indications, optimal patient selection, and most appropriate method of technically performing this procedure.
胃出口梗阻是晚期上消化道和胰腺恶性肿瘤的常见并发症。内镜超声（EUS）引导下胃空肠吻合术是一种新的选择，它可能提供比肠内支架置入更持久的解决方案，恢复时间更短，成本比外科胃空肠吻合术更低。执行该手术的技术包括直接EUS引导穿刺、球囊辅助和徒手方法。使用带烧灼头的管腔贴附金属支架可提高技术成功率并缩短手术时间。需要进行前瞻性研究，以比较EUS引导下胃空肠吻合术与肠内支架置入术和外科胃空肠吻合术，并明确适应证、最佳患者选择以及技术上执行该手术的最合适方法。
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