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논문 기본 정보

자료유형
학술저널
저자정보
Kenjiro Yamamoto (Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo Japan) Takao Itoi (Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo Japan)
저널정보
소화기인터벤션의학회 International Journal of Gastrointestinal Intervention International Journal of Gastrointestinal Intervention 제9권 제4호
발행연도
2020.1
수록면
177 - 183 (7page)

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Gastric outlet obstruction (GOO) can be caused by benign and malignant diseases. GOO often leads to a decreased quality of life, because of nausea, vomiting, and problems with oral food intake. Traditionally, surgical gastrojejunostomy (SGJ) has been the primary treatment for GOO. Endoscopic enteral stenting (EES) has also been carried out for the treatment of malignant GOO. In recent years, endoscopic ultrasonography-guided gastroenterostomy (EUS-GE) using a lumen apposing metal stent has emerged as a procedure to treat patients with GOO, as an alternative to surgery or to standard endoscopy when EES is not possible. Various techniques, such as direct EUS-GE, assisted EUS-GE, and EUS-guided balloon-occluded gastrojejunostomy bypass have been established to perform EUS-GE safety and accurately. Previous reports of EUS-GE with lumen apposing metal stent demonstrated that the technical and clinical success rates were 87% to 100% and 84% to 100%, respectively, without differentiating the various procedural techniques. The adverse events rate ranged from 0% to 18.1%, and included stent misdeployment, bleeding, peritonitis, leakage, abdominal pain, etc. In addition, the reintervention rate ranged from 0% to 15.1%. Moreover, a comparison of EUS-GE and SGJ showed that there was no significant difference in clinical success, rate of adverse events, or need for reintervention between these procedures. On the other hand, studies comparing EUS-GE with EES showed that EUS-GE may have higher clinical success and a lower rate of stent failure requiring repeated intervention than EES. Furthermore, EUS-GE has been used in several clinical scenarios, such as the management of endoscopic retrograde cholangiopancreatography in patients who underwent Roux-en-Y gastric bypass, or for the treatment of afferent loop syndrome. The present review describes the presently available EUS-GE techniques and introduces the recent clinical advances in the treatment of GOO.
#Endoscopic enteral stenting #Endoscopic ultrasonography-guided gastroenterostomy #Gastric outlet obstruction #Surgical gastrojejunostomy

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참고문헌 (56)

참고문헌 신청
van Hooft JE / 2009 / Efficacy and safety of the new WallFlex enteral stent in palliative treatment of malignant gastric outlet obstruction(DUOFLEX study) : a prospective multicenter study / Gastrointest Endosc 69:1059~1066 google schola Warshaw AL / 1992 / Pancreatic carcinoma / N Engl J Med 326:455~465 google schola van Heek NT / 2002 / Palliative treatment in "peri"-pancreatic carcinoma: stenting or surgical therapy? / Acta Gastroenterol Belg 65:171~175 google schola Johnsson E / 2004 / Palliation of malignant gastroduodenal obstruction with open surgical bypass or endoscopic stenting : clinical outcome and health economic evaluation / World J Surg 28:812~817 google schola Mehta S / 2006 / Prospective randomized trial of laparoscopic gastrojejunostomy versus duodenal stenting for malignant gastric outflow obstruction / Surg Endosc 20:239~242 google schola

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