Endoscopic ultrasound-guided drainage using lumen-apposing metal stent of malignant afferent limb syndrome in patients with previous Whipple surgery: Multicenter study (with video)

Autor: Enrique Pérez‐Cuadrado‐Robles, Michiel Bronswijk, Fréderic Prat, Marc Barthet, Maxime Palazzo, Paolo Arcidiacono, Marion Schaefer, Jacques Devière, Roy L. J. van Wanrooij, Ilaria Tarantino, Gianfranco Donatelli, Marine Camus, Andres Sanchez‐Yague, Khanh Do‐Cong Pham, Jean‐Michel Gonzalez, Andrea Anderloni, Juan J. Vila, Julien Jezequel, Alberto Larghi, Bénédicte Jaïs, Enrique Vazquez‐Sequeiros, Pierre H. Deprez, Schalk Van der Merwe, Christophe Cellier, Gabriel Rahmi
Přispěvatelé: UCL - (SLuc) Centre du cancer, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Service de gastro-entérologie, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Biomécanique Appliquée (LBA UMR T24), Aix Marseille Université (AMU)-Université Gustave Eiffel, Hôpital Nord [CHU - APHM], Hôpital Beaujon, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université libre de Bruxelles (ULB), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), BREST - Hépato-Gastro-Entérologie (BREST - HGE), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Gastroenterology and hepatology
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, Vol. 136, no.1, p. 1-7 (2022)
Pérez-Cuadrado-Robles, E, Bronswijk, M, Prat, F, Barthet, M, Palazzo, M, Arcidiacono, P, Schaefer, M, Devière, J, van Wanrooij, R L J, Tarantino, I, Donatelli, G, Camus, M, Sanchez-Yague, A, Pham, K D-C, Gonzalez, J-M, Anderloni, A, Vila, J J, Jezequel, J, Larghi, A, Jaïs, B N, Vazquez-Sequeiros, E, Deprez, P H, van der Merwe, S, Cellier, C & Rahmi, G 2022, ' Endoscopic ultrasound-guided drainage using lumen-apposing metal stent of malignant afferent limb syndrome in patients with previous Whipple surgery : Multicenter study (with video) ', Digestive endoscopy, vol. 34, no. 7, pp. 1433-1439 . https://doi.org/10.1111/den.14330
Digestive Endoscopy
Digestive Endoscopy, 2022, 34 (7), pp.1433-1439. ⟨10.1111/den.14330⟩
Digestive endoscopy, 34(7), 1433-1439. Wiley-Blackwell
ISSN: 0915-5635
1443-1661
Popis: OBJECTIVES: Endoscopic ultrasound-guided digestive anastomosis (EUS-A) is a new alternative under evaluation in patients presenting with afferent limb syndrome (ALS) after Whipple surgery. The aim of the present study is to analyze the safety and effectiveness of EUS-A in ALS. METHODS: This is an observational multicenter study. All patients ≥18 years old with previous Whipple surgery presenting with ALS who underwent an EUS-A using a lumen-apposing metal stent (LAMS) between 2015 and 2021 were included. The primary outcome was clinical success, defined as resolution of the ALS or ALS-related cholangitis. Furthermore, technical success, adverse event rate, and mortality were evaluated. RESULTS: Forty-five patients (mean age: 65.5 ± 10.2 years; 44.4% male) were included. The most common underlying disease was pancreatic cancer (68.9%). EUS-A was performed at a median of 6 weeks after local tumor recurrence. The most common approach used was the direct/freehand technique (66.7%). Technical success was achieved in 95.6%, with no differences between large (≥15 mm) and small LAMS (97.4% vs. 100%, P = 0.664). Clinical success was retained in 91.1% of patients. A complementary treatment by dilation of the stent followed by endoscopic retrograde cholangiopancreatography through the LAMS was performed in three cases (6.7%). There were six recurrent episodes of cholangitis (14.6%) and two procedure-related adverse events (4.4%) after a median follow-up of 4 months. Twenty-six patients (57.8%) died during the follow-up due to disease progression. CONCLUSION: EUS-A is a safe and effective technique in the treatment of malignant ALS, achieving high clinical success with an acceptable recurrence rate. ispartof: DIGESTIVE ENDOSCOPY vol:34 issue:7 pages:1433-1439 ispartof: location:Australia status: published
Databáze: OpenAIRE
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