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A case of cystic paraduodenal pancreatitis with gastric outlet obstruction: technical pitfalls in EUS-guided gastroenteroanastomosis.

ABSTRACT: Video 1Technical pitfalls in EUS-guided gastroenteroanastomosis in an 84-year-old man with gastric outlet obstruction owing to cystic paraduodenal pancreatitis.

SUBMITTER: Binda C

PROVIDER: S-EPMC9414579 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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A case of cystic paraduodenal pancreatitis with gastric outlet obstruction: technical pitfalls in EUS-guided gastroenteroanastomosis.

Binda Cecilia C Marocchi Gianmarco G Coluccio Chiara C Sbrancia Monica M Fabbri Carlo C

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 20220521 8

Video 1Technical pitfalls in EUS-guided gastroenteroanastomosis in an 84-year-old man with gastric outlet obstruction owing to cystic paraduodenal pancreatitis. ...[more]

PMID: 36034072

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Project description:Background and study aims Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has recently emerged as a potential treatment option for malignant gastric outlet obstruction (mGOO), with a relatively long duration of patency and low rate of reintervention. Its intrinsic risk for serious adverse events and high procedure cost mandates careful patient selection beyond the common safety profiles. This study aimed to assess for predictors of early post-EUS-GE mortality. Patients and methods We conducted a retrospective analysis of all patients with unresectable mGOO who underwent EUS-GE. Predictive factors for postoperative 30-day mortality with crude and adjusted hazard ratios were examined using univariate and multivariate penalized likelihood Firth logistic regression analyses. Results Technical and clinical success was achieved in 96.7% and 93.1% of the patients, respectively. The 30-day mortality rate after the procedure was 11.7%, and no procedure complications were observed. The 30-day mortality group had a significantly low rate of initial clinical success (66.7% vs. 96.2%, P = 0.007). Univariate analysis identified significantly higher postoperative 30-day mortality in patients with poor baseline ECOG performance status scale (≥ 2) and ascites. Presence of grade 2 ascites was confirmed as an independent predictive factor in the multivariate analysis (adjusted hazard ratio 52.41, 95% confidence interval 1.55 to 1775.64, P = 0.024). Conclusions EUS-GE should be carefully considered for patients with ascites which was an independent predictor for early mortality after procedure in mGOO, especially those with grade 2 or higher level of ascites.

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EUS-guided gastroenterostomy versus enteral stenting for gastric outlet obstruction: Systematic review and meta-analysis.

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EUS-guided gastroenterostomy versus surgical gastroenterostomy for the management of gastric outlet obstruction: a systematic review and meta-analysis.

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