PMID- 32617391 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20200928 IS - 2364-3722 (Print) IS - 2196-9736 (Electronic) IS - 2196-9736 (Linking) VI - 8 IP - 7 DP - 2020 Jul TI - Outcomes of biliopancreatic EUS in patients with surgically altered upper gastrointestinal anatomy: a multicenter study. PG - E869-E876 LID - 10.1055/a-1161-8713 [doi] AB - Background and study aims Little is known about outcomes of biliopancreatic endosonography (EUS) in patients with surgically altered upper gastrointestinal (gastrointestinal) anatomy. We aimed to assess the rate of procedural success and EUS-related adverse events (AEs), according to post-surgical anatomies. Patients and methods Retrospective study including patients with post-surgical altered upper gastrointestinal anatomy who underwent EUS for evaluation of the biliopancreatic region between January 2008 and June 2018 at eight European centers. Results Of 242 patients (162 males, mean age 66.4 +/- 12.5), 86 had (35.5 %) Billroth II, 77 (31.8 %) pancreaticoduodenectomy, 23 (9.5 %) Billroth I, 19 (7.9 %) distal esophagectomy, 15 (6.2 %) total gastrectomy, 14 (5.8 %) sleeve gastrectomy, and eight (3.3 %) Roux-en-Y. Sleeve gastrectomy, Billroth I, and pancreaticoduodenectomy were associated with high rates of success (100 %, 95.7 %, and 92.2 %, respectively). Visualization of the head of the pancreas was significantly impacted by total gastrectomy, Billroth II, and Roux-en-Y (success rates 6.7 %, 53.7 %, and 57.1 %, respectively). Examination of the pancreatic body and tail was impaired in esophagectomy and total gastrectomy (82.4 % and 71.4 %, respectively). Technical success and diagnostic accuracy of EUS-guided tissue acquisition (EUS-TA) was 78.2 % and 71.3 % (95 % CI, 60.6-80.5), respectively. Four (1.6 %) AEs were observed: one mucosal tearing in a Billroth II patient, one cardiac arrest in a distal esophagectomy patient, one bleed after EUS-TA in a Billroth I patient, and one acute pancreatitis after EUS-TA in a sleeve gastrectomy patient. Conclusions The yield of bilio-pancreatic EUS is dependent on lesion location and surgery type. Before considering EUS in these patients, one must carefully consider whether the lesion may be approachable by EUS. FAU - Brozzi, Lorenzo AU - Brozzi L AD - Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy. FAU - Petrone, Maria Chiara AU - Petrone MC AD - PancreatoBiliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Milan, Italy. FAU - Poley, Jan-Werner AU - Poley JW AD - Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. FAU - Carrara, Silvia AU - Carrara S AD - Humanitas Clinical and Research Center- IRCCS- Digestive Endoscopy Unit, Division of Gastroenterology, Rozzano (Milan), Italy. FAU - Barresi, Luca AU - Barresi L AD - Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Highly Specialized Therapies), Palermo, Italy. FAU - Fabbri, Carlo AU - Fabbri C AD - Unit of Gastroenterology and Digestive Endoscopy, Forli-Cesena Hospital, AUSL Romagna, Forli-Cesena, Italy. FAU - Rimbas, Mihai AU - Rimbas M AD - Gastroenterology Department, Colentina Clinical Hospital, Carol Davila University of Medicine, Bucharest, Romania. FAU - De Angelis, Claudio AU - De Angelis C AD - Gastroenterology and Digestive Endoscopy Unit, Citta della Salute e della Scienza di Torino, Turin, Italy. FAU - Arcidiacono, Paolo Giorgio AU - Arcidiacono PG AD - PancreatoBiliary Endoscopy and EUS Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Milan, Italy. FAU - Signoretti, Marianna AU - Signoretti M AD - Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. AD - Unit of Gastroenterology and Digestive Endoscopy, Forli-Cesena Hospital, AUSL Romagna, Forli-Cesena, Italy. FAU - Lamonaca, Laura AU - Lamonaca L AD - Humanitas Clinical and Research Center- IRCCS- Digestive Endoscopy Unit, Division of Gastroenterology, Rozzano (Milan), Italy. FAU - Barbuscio, Ilenia AU - Barbuscio I AD - Endoscopy Service, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Highly Specialized Therapies), Palermo, Italy. FAU - Binda, Cecilia AU - Binda C AD - Unit of Gastroenterology and Digestive Endoscopy, Forli-Cesena Hospital, AUSL Romagna, Forli-Cesena, Italy. FAU - Gheorghe, Andrada AU - Gheorghe A AD - Gastroenterology Department, Colentina Clinical Hospital, Carol Davila University of Medicine, Bucharest, Romania. FAU - Rizza, Stefano AU - Rizza S AD - Gastroenterology and Digestive Endoscopy Unit, Citta della Salute e della Scienza di Torino, Turin, Italy. FAU - Gabbrielli, Armando AU - Gabbrielli A AD - Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy. FAU - Crino, Stefano Francesco AU - Crino SF AD - Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy. LA - eng PT - Journal Article DEP - 20200616 PL - Germany TA - Endosc Int Open JT - Endoscopy international open JID - 101639919 PMC - PMC7297615 COIS- Competing interests The authors declare that they have no conflict of interest. EDAT- 2020/07/04 06:00 MHDA- 2020/07/04 06:01 PMCR- 2020/07/01 CRDT- 2020/07/04 06:00 PHST- 2020/01/26 00:00 [received] PHST- 2020/03/30 00:00 [accepted] PHST- 2020/07/04 06:00 [entrez] PHST- 2020/07/04 06:00 [pubmed] PHST- 2020/07/04 06:01 [medline] PHST- 2020/07/01 00:00 [pmc-release] AID - 10.1055/a-1161-8713 [doi] PST - ppublish SO - Endosc Int Open. 2020 Jul;8(7):E869-E876. doi: 10.1055/a-1161-8713. Epub 2020 Jun 16.