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Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience

Background: Endoscopic-ultrasound-guided gastrojejunostomy (EUS-GJ) can be a new alternative for patients with malignant afferent loop syndrome (MALS). However, a fully covered self-expandable metal stent (FCSEMS) has not been well investigated in this setting. Methods: This is a multicenter retrosp...

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Autores principales: Matsubara, Saburo, Takahashi, Sho, Takahara, Naminatsu, Nakagawa, Keito, Suda, Kentaro, Otsuka, Takeshi, Nakai, Yousuke, Isayama, Hiroyuki, Oka, Masashi, Nagoshi, Sumiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219552/
https://www.ncbi.nlm.nih.gov/pubmed/37240629
http://dx.doi.org/10.3390/jcm12103524
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author Matsubara, Saburo
Takahashi, Sho
Takahara, Naminatsu
Nakagawa, Keito
Suda, Kentaro
Otsuka, Takeshi
Nakai, Yousuke
Isayama, Hiroyuki
Oka, Masashi
Nagoshi, Sumiko
author_facet Matsubara, Saburo
Takahashi, Sho
Takahara, Naminatsu
Nakagawa, Keito
Suda, Kentaro
Otsuka, Takeshi
Nakai, Yousuke
Isayama, Hiroyuki
Oka, Masashi
Nagoshi, Sumiko
author_sort Matsubara, Saburo
collection PubMed
description Background: Endoscopic-ultrasound-guided gastrojejunostomy (EUS-GJ) can be a new alternative for patients with malignant afferent loop syndrome (MALS). However, a fully covered self-expandable metal stent (FCSEMS) has not been well investigated in this setting. Methods: This is a multicenter retrospective cohort study. Consecutive patients that underwent EUS-GJ using a FCSEMS for MALS between April 2017 and November 2022 were enrolled. Primary outcomes were technical and clinical success rates. Secondary outcomes were adverse events, recurrent symptoms, and overall survival. Results: Twelve patients (median age: 67.5 years (interquartile range: 58–74.8); 50% male) were included. The most common primary disease and type of previous surgery were pancreatic cancer (67%) and pancreatoduodenectomy (75%), respectively. Technical success and clinical success were achieved in all patients. Procedure-related adverse events occurred in one patient (8%) with mild peritonitis. During a median follow-up of 96.5 days, one patient (8%) had recurrent symptoms due to the EUS-GJ stent dysfunction; including biliary events unrelated to the EUS-GJ stent, five patients (42%) had recurrent events. The median overall survival was 137 days. Nine patients (75%) died due to disease progression. Conclusions: EUS-GJ with a FCSEMS seems safe and effective for MALS with high technical and clinical success rates and an acceptable recurrence rate.
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spelling pubmed-102195522023-05-27 Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience Matsubara, Saburo Takahashi, Sho Takahara, Naminatsu Nakagawa, Keito Suda, Kentaro Otsuka, Takeshi Nakai, Yousuke Isayama, Hiroyuki Oka, Masashi Nagoshi, Sumiko J Clin Med Article Background: Endoscopic-ultrasound-guided gastrojejunostomy (EUS-GJ) can be a new alternative for patients with malignant afferent loop syndrome (MALS). However, a fully covered self-expandable metal stent (FCSEMS) has not been well investigated in this setting. Methods: This is a multicenter retrospective cohort study. Consecutive patients that underwent EUS-GJ using a FCSEMS for MALS between April 2017 and November 2022 were enrolled. Primary outcomes were technical and clinical success rates. Secondary outcomes were adverse events, recurrent symptoms, and overall survival. Results: Twelve patients (median age: 67.5 years (interquartile range: 58–74.8); 50% male) were included. The most common primary disease and type of previous surgery were pancreatic cancer (67%) and pancreatoduodenectomy (75%), respectively. Technical success and clinical success were achieved in all patients. Procedure-related adverse events occurred in one patient (8%) with mild peritonitis. During a median follow-up of 96.5 days, one patient (8%) had recurrent symptoms due to the EUS-GJ stent dysfunction; including biliary events unrelated to the EUS-GJ stent, five patients (42%) had recurrent events. The median overall survival was 137 days. Nine patients (75%) died due to disease progression. Conclusions: EUS-GJ with a FCSEMS seems safe and effective for MALS with high technical and clinical success rates and an acceptable recurrence rate. MDPI 2023-05-17 /pmc/articles/PMC10219552/ /pubmed/37240629 http://dx.doi.org/10.3390/jcm12103524 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Matsubara, Saburo
Takahashi, Sho
Takahara, Naminatsu
Nakagawa, Keito
Suda, Kentaro
Otsuka, Takeshi
Nakai, Yousuke
Isayama, Hiroyuki
Oka, Masashi
Nagoshi, Sumiko
Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience
title Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience
title_full Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience
title_fullStr Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience
title_full_unstemmed Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience
title_short Endoscopic Ultrasound-Guided Gastrojejunostomy for Malignant Afferent Loop Syndrome Using a Fully Covered Metal Stent: A Multicenter Experience
title_sort endoscopic ultrasound-guided gastrojejunostomy for malignant afferent loop syndrome using a fully covered metal stent: a multicenter experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10219552/
https://www.ncbi.nlm.nih.gov/pubmed/37240629
http://dx.doi.org/10.3390/jcm12103524
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