Clinical Endoscopy

Original Article

Comparative retrospective outcomes of endoscopic ultrasound-guided gastroenterostomy in patients with gastric outlet obstruction and post-surgical anatomy: Michiel Bronswijk, Jan Clerick, Giuseppe Vanella, Jayanta Samanta, Roy L.J. van Wanrooij, Schalk Van der Merwe; Clin Endosc 2026;59(3):417-424. Published online May 28, 2026; DOI: https://doi.org/10.5946/ce.2025.268

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: Data on endoscopic ultrasound (EUS)-guided gastroenterostomy (EUS-GE) are mainly derived from patients with naïve anatomy. This study aimed to evaluate the outcomes of EUS-GE in patients with post-surgical anatomy and compare these findings with those from a cohort of patients with naïve anatomy.
Methods
A retrospective tertiary center analysis was performed of consecutive EUS-GE procedures. The wireless-EUS-GE-simplified technique (WEST) was employed for EUS-GE. Clinical success was defined as achieving a postprocedural gastric outlet obstruction scoring system score of ≥2.
Results
Overall, 10 patients with post-surgical anatomy and 63 sequential historical controls with naïve anatomy were included from the same time frame (2019–2022). Surgery consisted predominantly of Whipple resection (n=3) or partial gastrectomy (n=2). Clinical success was achieved in 90.0% and 90.5% of patients in the post-surgical and naïve anatomy groups, respectively (p=1.000). Technical success (90.0% vs. 96.8%, p=0.362), median hospital stay (8 vs. 6 days, p=0.397), adverse event rate (10.0% vs. 7.9%, p=1.000), and median follow-up duration (186 vs. 136 days, p=0.303) were comparable between the two groups. However, the median procedure duration was significantly longer in the post-surgical anatomy group compared to that in the naïve group (61 vs. 45 minutes, p=0.037).
Conclusions
Although increased technical complexity and a limited sample size should be considered, our comparative data suggest that EUS-GE was equally effective in patients with post-surgical anatomy.

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Commentary

Submucosal Epinephrine Injection Before Endoscopic Papillectomy: Less is More?: Roy L.J. van Wanrooij, Jeanin E. van Hooft; Clin Endosc 2021;54(5):627-628. Published online August 24, 2021; DOI: https://doi.org/10.5946/ce.2021.173

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Citations

Citations to this article as recorded by

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