EUS-guided gastroenterostomy: a multicenter study comparing the direct and balloon-assisted techniques.

Area of Science:

• Gastroenterology
• Endoscopic procedures
• Surgical innovation

Background:

• Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is an emerging treatment for gastric outlet obstruction (GOO).
• Existing EUS-GE techniques include direct and balloon-assisted methods.
• The role of EUS-GE in GOO management requires further definition.

Purpose of the Study:

• To compare the technical success and clinical outcomes of direct versus balloon-assisted EUS-GE.
• To evaluate procedure time and adverse events for both EUS-GE techniques.
• To further establish the utility of EUS-GE in managing GOO.

Main Methods:

• A multicenter, retrospective study of patients undergoing EUS-GE for GOO from January 2014 to October 2016.
• Patients were divided into direct (n=52) and balloon-assisted (n=22) technique groups.
• Primary outcome: technical success. Secondary outcomes: clinical success, procedure time, adverse events.

Main Results:

• Technical success rates were high and similar for both techniques (direct: 94.2%, balloon-assisted: 90.9%).
• The direct technique demonstrated significantly shorter procedure times (35.7 min vs 89.9 min).
• Clinical success rates were comparable (direct: 92.3%, balloon-assisted: 90.9%), with low adverse event rates.

Conclusions:

• EUS-GE is a safe and effective endoscopic treatment for gastric outlet obstruction.
• The direct EUS-GE technique may be preferable due to its shorter procedural duration.
• Further prospective studies are warranted to validate these findings.