Long-Term Outcomes of EUS-Guided Gastroenterostomy: A Large, Single-Center Experience

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Surgical Oncology

Background:

• Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is an established procedure for both benign and malignant conditions.
• Limited data exists regarding the long-term outcomes and stent-related adverse events (AEs) following EUS-GE.
• This study aims to evaluate the long-term results and safety profile of EUS-GE.

Purpose of the Study:

• To assess the long-term outcomes of patients undergoing EUS-GE.
• To identify and analyze stent-related adverse events (AEs) associated with EUS-GE.
• To evaluate the efficacy of EUS-GE in various clinical scenarios.

Main Methods:

• Retrospective analysis of 207 patients who underwent EUS-GE between January 1, 2014, and December 31, 2022, at a tertiary care institution.
• Inclusion of patients with both benign and malignant indications for EUS-GE.
• Follow-up of patients for at least 3 months post-procedure to record outcomes and AEs.

Main Results:

• High technical success rate of 95.7% in 207 patients (56.5% malignant, 43.5% benign indications).
• Mean follow-up of 406 days; 63.6% of stents remained in place for ≥3 months, and 21% for ≥1 year.
• Late AEs occurred in 3.4% of patients; no late AEs were observed in stent-dependent patients with annual stent exchanges.

Conclusions:

• EUS-GE demonstrates favorable long-term outcomes with a low incidence of adverse events.
• Proactive annual stent exchange is recommended for patients requiring long-term EUS-GE to prevent complications like stent delamination and occlusion.
• EUS-GE is increasingly valuable for accessing the gastrointestinal tract in cases of altered anatomy, gastric outlet obstruction (GOO), and as a bridge to surgery.