Endoscopic Ultrasound-Guided Gastrojejunostomy

Sunil Amin; Amrita Sethi

doi:10.1016/j.giec.2017.06.009

Endoscopic Ultrasound-Guided Gastrojejunostomy

Gastrointest Endosc Clin N Am. 2017 Oct;27(4):707-713. doi: 10.1016/j.giec.2017.06.009.

Authors

Sunil Amin¹, Amrita Sethi²

Affiliations

¹ Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, 161 Fort Washington Avenue, 852A, New York, NY 10032, USA.
² Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, 161 Fort Washington Avenue, 852A, New York, NY 10032, USA. Electronic address: as3614@cumc.columbia.edu.

PMID: 28918806
DOI: 10.1016/j.giec.2017.06.009

Abstract

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.

Keywords: Anastomosis; Endoscopic ultrasonography; Gastric outlet obstruction; Gastrojejunostomy; Lumen-apposing metal stent.

Publication types

Review

MeSH terms

Endosonography*
Gastric Bypass / methods*
Gastric Outlet Obstruction / surgery*
Humans
Prospective Studies
Stents