C0687 - A Retrospective Series on Efficacy and Course With Endoscopic Follow-Up of Endoscopic Ultrasound-Guided Gastroenterostomy (EUS-GE) for Benign Gastric Outlet Obstruction (GOO)

Youssef Soliman, MD¹, William Abel, MD¹, Shravani Reddy, MD¹, Varun Kesar, MD¹, Paul Yeaton, MD¹, Vivek Kesar, MD^2
1Virginia Tech Carilion School of Medicine, Roanoke, VA; ²Virginia Tech Carilion, Roanoke, VA

Introduction: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has gained popularity in treating malignant gastric outlet obstruction (GOO). EUS-GE has also been used to manage benign GOO with impressive technical and clinical success. The long-term efficacy and course of EUS-GE in benign GOO are important to understand given the relatively longer follow-up available, compared to malignant GOO. The aim of this study was to report on efficacy and course of EUS-GE in benign GOO.

Methods: This was a single center retrospective series. Consecutive patients who underwent EUS-GE from 1/2017 to 5/2022 for treatment of benign GOO were included. The primary outcomes were technical and clinical success. The secondary outcomes included prior endoscopic treatment, adverse events, and follow-up (clinical and endoscopic).

Results: A total of 16 patients (43.75% female; mean age 63.3 +/- 14.8 years) underwent EUS-GE for benign GOO. The etiologies included: pancreatitis (n=5), peptic stricture (n=3), non-specified inflammatory (n=3), SMA syndrome (n=2), prior anastomotic stricture (n=1), radiation-induced stricture (n=1), and hematoma (n=1). Prior endoscopic treatment was attempted in 31.25%. EUS-GE technical success and clinical success were 100%. Adverse events occurred in 12.5% of cases. Re-intervention rate was 12.5%. The 20 x 10 mm lumen-apposing stent was used in 75% of cases. The median clinical follow-up was 148.5 days (range 9 – 1444). Endoscopic follow-up was available in 9 (56.25%) cases. Of those, 3 (33.3%) had jejunal mucosal ulceration (with one fistulizing with the left ureter), while the remainder (66.7%) had normal jejunal mucosa.

Discussion: This series adds to growing literature that EUS-GE for benign GOO is technically feasible and clinically beneficial. Unique to this series is the comment on the appearance of jejunal mucosa on endoscopic follow-up. This is an important aspect of long-term assessment of EUS-GE, especially when compared to surgical gastroenterostomy where marginal and non-marginal jejunal ulcers are possible. Major limitations of this study include the single center retrospective nature and the overall small sample size. Larger and prospective data are needed to further describe the clinical course of EUS-GE for benign GOO.


Disclosures:


Youssef Soliman, MD¹, William Abel, MD¹, Shravani Reddy, MD¹, Varun Kesar, MD¹, Paul Yeaton, MD¹, Vivek Kesar, MD². C0687 - A Retrospective Series on Efficacy and Course With Endoscopic Follow-Up of Endoscopic Ultrasound-Guided Gastroenterostomy (EUS-GE) for Benign Gastric Outlet Obstruction (GOO), ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.