PMID- 35571468
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 10
IP  - 5
DP  - 2022 May
TI  - Efficacy and safety of endoscopic ultrasound-guided gastrojejunostomy in patients 
      with malignant gastric outlet obstruction and ascites.
PG  - E670-E678
LID - 10.1055/a-1797-9318 [doi]
AB  - Background and study aims  Endoscopic ultrasound-guided gastrojejunostomy 
      (EUS-GJ) is an endoscopic procedure for treating gastric outlet obstruction 
      (GOO). Limited data exist regarding the safety and efficacy of EUS-GJ in patients 
      with malignant GOO with ascites. Thus, we aimed to study the outcomes and safety 
      of EUS-GJ in GOO patients with vs. without ascites. Patients and methods  This is 
      a retrospective cohort study of patients with malignant GOO who underwent 
      successful EUS-GJ at a tertiary care academic center. Primary outcomes included 
      the efficacy and safety of EUS-GJ. Secondary outcomes included 30-day 
      readmission, reintervention, and survival utilizing Kaplan-Meier analysis. 
      Results  A total of 55 patients (mean age of 67.0 +/- 11.3 years, 40.0 % female) 
      who underwent EUS-GJ, of whom 24 had ascites (small in 22, large in 2) were 
      included. Clinical success was achieved in 91.7 % and 93.5 % ( P =  1.00) of 
      patients with and without ascites, respectively. A higher rate of adverse events 
      (AEs) was noted in patients with ascites but this was not statistically 
      significant (37.5 % vs. 19.4 %, P =  0.13). Four patients in the ascites group 
      (16.6 %) developed clinical evidence of peritonitis or sepsis post-EUS-GJ. Eight 
      patients with ascites developed worsening ascites within a month of EUS-GJ. In 
      contrast, only one patient without ascites developed evidence of new ascites. The 
      median survival of patients was not significantly different between the two 
      groups (patients with ascites: 129 days vs. patients without ascites: 180 days, ( 
      P =  0.12). Conclusions  The efficacy EUS-GJ in the presence of ascites is 
      promising; however, the safety profile remains concerning given the high rate of 
      AEs, specifically peritonitis and sepsis.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Mahmoud, Tala
AU  - Mahmoud T
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Storm, Andrew C
AU  - Storm AC
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Law, Ryan J
AU  - Law RJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Jaruvongvanich, Veeravich
AU  - Jaruvongvanich V
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Ghazi, Rabih
AU  - Ghazi R
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Abusaleh, Rami
AU  - Abusaleh R
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Vargas, Eric J
AU  - Vargas EJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Bazerbachi, Fateh
AU  - Bazerbachi F
AD  - Interventional Endoscopy Program, CentraCare Digestive Center, St. Cloud 
      Hospital, St. Cloud, Minnesota, United States.
FAU - Levy, Michael J
AU  - Levy MJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Truty, Mark J
AU  - Truty MJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Chandrasekhara, Vinay
AU  - Chandrasekhara V
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
FAU - Abu Dayyeh, Barham K
AU  - Abu Dayyeh BK
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, 
      United States.
LA  - eng
PT  - Journal Article
DEP - 20220513
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC9106441
COIS- Competing interests Dr. Abu Dayyeh is a consultant for USGI, Medtronic, Boston 
      Scientific, Hemostasis, Endogenex, and the recipient of research support from 
      Apollo Endosurgery, USGI, Boston Scientific, Endogastric Solutions and Medtronic 
      and a speaker for Olympus, Medtronic and Johnson and Johnson. Dr. Storm is a 
      consultant for Apollo Endosurgery, GI Dynamics, Olympus, ERBE, and Enterasense, 
      and the recipient of research support from Apollo Endosurgery, Endo-TAGSS, and 
      Boston Scientific. Dr. Law is a consultant for ConMed and Medtronic. Dr. 
      Chandrasekhara is a consultant for Interpace Diagnostics and Covidien LP, and a 
      shareholder at Nevakar Corporation.
EDAT- 2022/05/17 06:00
MHDA- 2022/05/17 06:01
PMCR- 2022/05/01
CRDT- 2022/05/16 03:59
PHST- 2021/10/19 00:00 [received]
PHST- 2022/02/22 00:00 [accepted]
PHST- 2022/05/16 03:59 [entrez]
PHST- 2022/05/17 06:00 [pubmed]
PHST- 2022/05/17 06:01 [medline]
PHST- 2022/05/01 00:00 [pmc-release]
AID - 10.1055/a-1797-9318 [doi]
PST - epublish
SO  - Endosc Int Open. 2022 May 13;10(5):E670-E678. doi: 10.1055/a-1797-9318. 
      eCollection 2022 May.