PMID- 29730228
OWN - NLM
STAT- MEDLINE
DCOM- 20181214
LR  - 20181214
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Linking)
VI  - 88
IP  - 3
DP  - 2018 Sep
TI  - An international, multicenter, comparative trial of EUS-guided 
      gastrogastrostomy-assisted ERCP versus enteroscopy-assisted ERCP in patients with 
      Roux-en-Y gastric bypass anatomy.
PG  - 486-494
LID - S0016-5107(18)32667-1 [pii]
LID - 10.1016/j.gie.2018.04.2356 [doi]
AB  - BACKGROUND AND AIMS: ERCP is challenging in patients with Roux-en-Y gastric 
      bypass (RYGB) anatomy. EUS-guided gastrogastrostomy (GG) creation is a promising 
      novel technique to access the excluded stomach to facilitate conventional ERCP. 
      We aimed to compare procedural outcomes and adverse events (AEs) between 
      EUS-guided GG-assisted ERCP (EUS-GG-ERCP) and enteroscopy-assisted ERCP (e-ERCP) 
      in patients with RYGB. METHODS: Patients with RYGB anatomy who underwent 
      EUS-GG-ERCP or e-ERCP between 2014 and 2016 at 5 tertiary centers were included. 
      The primary outcome was technical success of ERCP, defined as successful 
      cannulation of the selected duct with successful intervention as intended. 
      Secondary outcomes included total procedural time (in the EUS-GG group, total 
      procedural time included EUS-GG creation plus ERCP procedure time), length of 
      hospital stay, and rate/severity of AEs graded according to the American Society 
      for Gastrointestinal Endoscopy lexicon. RESULTS: A total of 60 patients (mean 
      age, 57.2 +/- 13.2; 75% women) were included, of whom 30 (50%) underwent 
      EUS-GG-ERCP and 30 (50%) underwent e-ERCP (double-balloon enteroscope ERCP, 19; 
      single-balloon enteroscope ERCP, 11). The technical success rate was 
      significantly higher in the EUS-GG-ERCP versus the e-ERCP group (100% vs 60.0%, 
      P < .001). Total procedure time was significantly shorter in patients who 
      underwent EUS-GG-ERCP (49.8 minutes vs 90.7 minutes, P < .001). Postprocedure 
      median length of hospitalization was shorter in the EUS-GG group (1 vs 10.5 days, 
      P = .02). Rate of AEs was similar in both groups (10% vs 6.7%, P = 1). 
      CONCLUSIONS: EUS-GG-ERCP may be superior to e-ERCP in patients with RYGB anatomy 
      in terms of a higher technical success and shorter procedural times and offers a 
      similar safety profile.
CI  - Copyright (c) 2018 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Bukhari, Majidah
AU  - Bukhari M
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA; Division of Medicine and Gastroenterology and 
      Hepatology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi 
      Arabia.
FAU - Kowalski, Thomas
AU  - Kowalski T
AD  - Division of Gastroenterology and Hepatology, Jefferson University School of 
      Medicine, Philadelphia, Pennsylvania, USA.
FAU - Nieto, Jose
AU  - Nieto J
AD  - Borland-Groover Clinic, Jacksonville, Florida, USA.
FAU - Kunda, Rastislav
AU  - Kunda R
AD  - Department of Surgical Gastroenterology, Aarhus University Hospital, Aarhus, 
      Denmark.
FAU - Ahuja, Nitin K
AU  - Ahuja NK
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Irani, Shayan
AU  - Irani S
AD  - Division of Gastroenterology and Hepatology, Virginia Mason Medical Center, 
      Seattle, Washington, USA.
FAU - Shah, Apeksha
AU  - Shah A
AD  - Division of Gastroenterology and Hepatology, Jefferson University School of 
      Medicine, Philadelphia, Pennsylvania, USA.
FAU - Loren, David
AU  - Loren D
AD  - Division of Gastroenterology and Hepatology, Jefferson University School of 
      Medicine, Philadelphia, Pennsylvania, USA.
FAU - Brewer, Olaya
AU  - Brewer O
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Sanaei, Omid
AU  - Sanaei O
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Chen, Yen-I
AU  - Chen YI
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Ngamruengphong, Saowanee
AU  - Ngamruengphong S
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Kumbhari, Vivek
AU  - Kumbhari V
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Singh, Vikesh
AU  - Singh V
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Aridi, Hanaa Dakour
AU  - Aridi HD
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
FAU - Khashab, Mouen A
AU  - Khashab MA
AD  - Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 
      Baltimore, Maryland, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20180503
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
SB  - IM
CIN - Gastrointest Endosc. 2019 Mar;89(3):646-648. PMID: 30784504
CIN - Gastrointest Endosc. 2019 Mar;89(3):646. PMID: 30784505
CIN - Gastrointest Endosc. 2019 Apr;89(4):904-905. PMID: 30902220
CIN - Gastrointest Endosc. 2019 Apr;89(4):905-907. PMID: 30902221
MH  - Adult
MH  - Aged
MH  - Anastomosis, Surgical
MH  - Bile Duct Diseases/complications/diagnosis/therapy
MH  - Cholangiopancreatography, Endoscopic Retrograde/*methods
MH  - Digestive System Diseases/complications/diagnosis/*therapy
MH  - *Endoscopy, Gastrointestinal
MH  - *Endosonography
MH  - Female
MH  - *Gastric Bypass
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity/complications/*surgery
MH  - Pancreatitis/complications/diagnosis/therapy
MH  - Prosthesis Implantation
MH  - Retrospective Studies
MH  - Stents
MH  - Stomach/surgery
EDAT- 2018/05/08 06:00
MHDA- 2018/12/15 06:00
CRDT- 2018/05/07 06:00
PHST- 2017/04/14 00:00 [received]
PHST- 2018/04/24 00:00 [accepted]
PHST- 2018/05/08 06:00 [pubmed]
PHST- 2018/12/15 06:00 [medline]
PHST- 2018/05/07 06:00 [entrez]
AID - S0016-5107(18)32667-1 [pii]
AID - 10.1016/j.gie.2018.04.2356 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2018 Sep;88(3):486-494. doi: 10.1016/j.gie.2018.04.2356. 
      Epub 2018 May 3.