EUS-Directed transDuodenal ERCP in Concomitant Gastric Outlet and Biliary Obstruction.

Autor: Kesar V; Virginia Tech Carilion, Division of Gastroenterology, Roanoke, Virginia., Abel WF; Virginia Tech Carilion, Department of Internal Medicine, Roanoke, Virginia. Electronic address: wfabel@carilionclinic.org., Bapaye J; Virginia Tech Carilion, Division of Gastroenterology, Roanoke, Virginia., Wasserman RD; Virginia Tech Carilion, Department of Internal Medicine, Roanoke, Virginia., Rozenberg J; Virginia Tech Carilion, Department of Internal Medicine, Roanoke, Virginia., Garikipati S; Virginia Tech Carilion, Division of Gastroenterology, Roanoke, Virginia., Mönkemüller KE; Virginia Tech Carilion, Division of Gastroenterology, Roanoke, Virginia., Kesar V; Virginia Tech Carilion, Division of Gastroenterology, Roanoke, Virginia., Yeaton P; Virginia Tech Carilion, Division of Gastroenterology, Roanoke, Virginia.
Jazyk: angličtina
Zdroj: Gastrointestinal endoscopy [Gastrointest Endosc] 2024 Dec 09. Date of Electronic Publication: 2024 Dec 09.
DOI: 10.1016/j.gie.2024.12.003
Abstrakt: Background and Aims: Patients with concomitant gastric outlet obstruction (GOO) and biliary obstruction often have limited management options, particularly in the setting of severe debility. We detail the use of EUS guided gastro-duodenal placement of lumen apposing metal stent (LAMS) as a conduit for transduodenal ERCP: EUS-Directed transDuodenal ERCP (EDDE).
Methods: Nine patients that developed GOO with indwelling biliary metal stents or with anticipated biliary stent placement were retrospectively included.
Results: A 20 mm x 10 mm LAMS deployed for creation of gastroduodenostomy in all patients. ERCP was performed via the gastroduodenal LAMS with resolution of jaundice in 100% of patients. GOOSS score improved to 3 in all patients.
Conclusions: This study demonstrates excellent outcomes (resolution of jaundice and GOO) in all chronically ill, poor surgical candidates. LAMS allowed for both, treatment of GOO and for ERCP access for present and future stent exchange.
(Copyright © 2024 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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