Trieu Judy A, Kahlenberg Sam, Gilman Andrew J, Hathorn Kelly, Baron Todd H
Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA.
Department of Internal Medicine, University of North Carolina, Chapel Hill, North Carolina, USA .
Clin Transl Gastroenterol. 2025 Jan 1;16(1):e00648. doi: 10.14309/ctg.0000000000000648.
Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is effective and safe in benign and malignant indications. However, there is a paucity of literature on the outcomes of these patients. Our study evaluates the long-term outcomes of patients who underwent EUS-GE and stent-related adverse events (AEs).
This retrospective study was performed at a tertiary care institution from January 1, 2014, to December 31, 2022. Patients who underwent EUS-GE were included. Procedure details and outcomes were recorded. Patients were followed for at least 3 months after the procedure.
A total of 207 patients (50.3% male, mean age 62.3 years) underwent EUS-GE for malignant (N = 117, 56.5%) and benign (N = 90, 43.5%) indications. Overall technical success was 95.7%. Patients were followed for a mean of 406 days. Stents were removed in 25.6% of patients; common reasons include completed access for endoscopic retrograde cholangiopancreatography (N = 13, 25%), resection/resolution of gastric outlet obstruction (GOO) (N = 28, 53.8%), and surgical resection of malignant GOO (N = 8, 15.4%). EUS-GE stents remained in place in 63.6% of patients for ≥3 months and in 21% of patients for ≥1 year. Late AEs occurred in 3.4%. Among patients who were stent-dependent (N = 24, 11.6%) and underwent annual stent exchanges, no late AEs occurred.
Long-term outcomes of EUS-GE are promising with few AEs, particularly with pre-emptive annual exchanges of stents to prevent stent delamination and occlusion among patients who require long-term indwelling stents. EUS-GE plays an increasing role in access for endoscopic retrograde cholangiopancreatography in altered anatomy, acute or chronic management of benign GOO, or bridge to definitive surgery for GOO.
内镜超声引导下胃肠造口术（EUS-GE）在良性和恶性适应症中均有效且安全。然而，关于这些患者结局的文献较少。我们的研究评估了接受EUS-GE治疗患者的长期结局以及与支架相关的不良事件（AE）。
这项回顾性研究于2014年1月1日至2022年12月31日在一家三级医疗机构进行。纳入接受EUS-GE治疗的患者。记录手术细节和结局。术后对患者进行至少3个月的随访。
共有207例患者（男性占50.3%，平均年龄62.3岁）因恶性（N = 117，56.5%）和良性（N = 90，43.5%）适应症接受EUS-GE治疗。总体技术成功率为95.7%。患者平均随访406天。25.6%的患者取出了支架；常见原因包括完成内镜逆行胰胆管造影的通路建立（N = 13，25%）、胃出口梗阻（GOO）的切除/缓解（N = 28，53.8%）以及恶性GOO的手术切除（N = 8，15.4%）。63.6%的患者EUS-GE支架留置≥3个月，21%的患者留置≥1年。晚期不良事件发生率为3.4%。在依赖支架的患者（N = 24，11.6%）中，每年进行支架更换，未发生晚期不良事件。
EUS-GE的长期结局良好，不良事件较少，特别是对于需要长期留置支架的患者，通过每年预防性更换支架可预防支架分层和闭塞。EUS-GE在解剖结构改变时内镜逆行胰胆管造影的通路建立、良性GOO的急性或慢性管理或GOO确定性手术的过渡中发挥着越来越重要的作用。
