Classification, outcomes, and management of misdeployed stents during EUS-guided gastroenterostomy

Ghandour, Bachir; Bejjani, Michael; Irani, Shayan; Sharaiha, Reem Z.; Kowalski, Thomas E.; Pleskow, Douglas K.; Pham, Khanh Do-Cong; Anderloni, Andrea; Martínez‐Moreno, Belén; Khara, Harshit S.; DʼSouza, Lionel S.; Lajin, Michael; Paranandi, Bharat; Súbtil, José Carlos; Fabbri, Carlo; Weber, Tobias; Barthet, Marc; Khashab, Mouen A.; Westerveld, Donevan; Bashir, Muhammad H.; Alrajhi, Saad; Aparicio, José Ramón; Confer, Bradley; Huggett, Matthew T.; Peralta-Herce, Sandra; Binda, Cecilia; Messman, Helmut; Sanaei, Omid; Holmes, Ian

doi:10.1016/j.gie.2021.07.023

Cited by 74 publications

(82 citation statements)

References 31 publications

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“…In recent reviews, reported complications associated with EUS-GE are ranging around 12%, including postinterventional pain, bleeding, stent obstruction, stent migration, peritonitis and LAMS misdeployment [ 4 , 12 , 17 , 18 ]. A recent multicenter study by Ghandour et al reported a total of 9.85% (46/467) stent misdeployments counting for one of the most important complications of EUS-GE [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Hybrid gastroenterostomy using a lumen-apposing metal stent: a case report focusing on misdeployment and systematic review of the current literature

Fabbri¹,

Binda²,

Fugazzola

et al. 2022

World J Emerg Surg

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Background Gastric outlet obstruction can result from several benign and malignant diseases, in particular gastric, duodenal or pancreatic tumors. Surgical gastroenterostomy and enteral endoscopic stenting have represented effective therapeutic options, although recently endoscopic ultrasound-guided gastroenterostomy using lumen-apposing metal stent (LAMS) is spreading improving the outcome of this condition. However, this procedure, although mini-invasive, is burdened with not negligible complications, including misdeployment. Main body We report the case of a 60-year-old male with gastric outlet obstruction who underwent ultrasound-guided gastroenterostomy using LAMS. The procedure was complicated by LAMS misdeployment being managed by laparoscopy-assisted placement of a second LAMS. We performed a systematic review in order to identify all reported cases of misdeployment in EUS-GE and their management. The literature shows that misdeployment occurs in up to 10% of all EUS-GE procedures with a wide spectrum of possible strategies of treatment. Conclusion The here reported hybrid technique may offer an innovative strategy to manage LAMS misdeployment when this occurs. Moreover, a hybrid approach may be valuable to overcome this complication, especially in early phases of training of EUS-guided gastroenterostomy.

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Section: Discussionmentioning

confidence: 99%

Hybrid gastroenterostomy using a lumen-apposing metal stent: a case report focusing on misdeployment and systematic review of the current literature

Fabbri¹,

Binda²,

Fugazzola

et al. 2022

World J Emerg Surg

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“…3,4 Technical failure and adverse events associated with EUS-GJ are commonly related to stent misdeployment. 5 Increased familiarity with this technique has been shown to mitigate these complications.…”

Section: Discussionmentioning

confidence: 99%

EUS-guided gastrojejunostomy for management of malignant gastric outlet obstruction in a patient with Roux-en-Y anatomy

Campbell

Pawa²

2022

VideoGIE

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“…The treatment consisted of stent removal and endoscopic closure of the gastric defect, followed by another attempt of EUS-GE. 35 From our experience, tips to minimize adverse events related to LAMS misplacement are as follow: 33 1. The procedure should always be performed under general anesthesia.…”

Section: Adverse Eventsmentioning

confidence: 99%

Endoscopic ultrasound-guided gastroenterostomy (gastroenteric anastomosis)

Oliveira

Franco

Rodela

et al. 2022

Int J Gastrointest Interv

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Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has emerged as a promising minimally invasive technique for patients with gastric outlet obstruction (GOO), regardless of whether a benign or malignant condition impedes gastric emptying. EUS-GE involves creating a bypass from the stomach to the small bowel distally to the obstruction, which is similar to the surgical gastroenteric anastomosis. In fact, EUS-GE has been reported to have longer stent patency in patients with malignant GOO than conventional self-expandable metal stents deployed across a malignant obstruction. Although surgical treatment is still considered the gold-standard treatment for patients with malignant GOO, the results of recent studies have shown not only similar rates of technical and clinical success with EUS-GE, but also lower rates of adverse events. In this review, we aimed to appraise the current status of EUS-GE, describe the multiple techniques to perform this procedure, compare the outcomes of EUS-GE with those of other therapeutic modalities, and discuss the related adverse events and the future perspectives of EUS-GE.

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Classification, outcomes, and management of misdeployed stents during EUS-guided gastroenterostomy

Cited by 74 publications

References 31 publications

Hybrid gastroenterostomy using a lumen-apposing metal stent: a case report focusing on misdeployment and systematic review of the current literature

Hybrid gastroenterostomy using a lumen-apposing metal stent: a case report focusing on misdeployment and systematic review of the current literature

EUS-guided gastrojejunostomy for management of malignant gastric outlet obstruction in a patient with Roux-en-Y anatomy

Endoscopic ultrasound-guided gastroenterostomy (gastroenteric anastomosis)

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