Endoscopic ultrasound-directed transgastric ERCP (EDGE): a systematic review describing the outcomes, adverse events, and knowledge gaps

Prakash, Shaurya; Elmunzer, B. Joseph; Förster, E; Coté, Gregory A.; Moran, Robert A.

doi:10.1055/a-1376-2394

Cited by 45 publications

(47 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A recent systematic review evaluated nine case series and eight case reports. In the case series, 169 patients underwent EDGE with a technical success rate of 99 % (168/169) for gastrogastrostomy/jejunogastrostomy creation and 98 % (166/169) for subsequent ERCP [184]. A recent study that compared LA-ERCP with EA-ERCP found both techniques to be similar with regards to technical success, AE rates, and procedure time [187] (Table 11 s).…”

Section: Key Question 22: What Are the Technical And Clinical Success Rates Of Edge?mentioning

confidence: 99%

“…Stent maldeployment can be adequately managed by endoscopy in the large majority of cases, reducing the likelihood of severe AEs, such as peritonitis, and/or death [147,164,182]. Long-term AEs in patients with EUS-guided lumento-lumen anastomoses include stent migration [148,183,184], obstruction by food residue [148], and tissue ingrowth [180] or overgrowth [145].…”

Section: Key Question 20: What Are the Most Common Adverse Events Associated With Eus-ge?mentioning

confidence: 99%

Section: Biliary Drainage In Patients Who Have Undergone Roux-en-y Gastric Bypassmentioning

confidence: 99%

“…A recent systematic review reported AEs related to the EDGE procedure in 24 % of cases (41/169) 184 . Most of the EDGE-related AEs (31/41) were minor, with 19/41 due to intraprocedural stent migration and eight due to stent maldeployment – these AEs could all be managed endoscopically – while post-procedural abdominal pain was reported in the remaining patients.…”

Section: Biliary Drainage In Patients Who Have Undergone Roux-en-y Gastric Bypassmentioning

confidence: 99%

See 3 more Smart Citations

Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

et al. 2021

View full text Add to dashboard Cite

Main Recommendations 1 ESGE recommends the use of endoscopic ultrasound-guided biliary drainage (EUS-BD) over percutaneous transhepatic biliary drainage (PTBD) after failed endoscopic retrograde cholangiopancreatography (ERCP) in malignant distal biliary obstruction when local expertise is available.Strong recommendation, moderate quality evidence. 2 ESGE suggests EUS-BD with hepaticogastrostomy only for malignant inoperable hilar biliary obstruction with a dilated left hepatic duct when inadequately drained by ERCP and/or PTBD in high volume expert centers.Weak recommendation, moderate quality evidence. 3 ESGE recommends that EUS-guided pancreatic duct (PD) drainage should only be considered in symptomatic patients with an obstructed PD when retrograde endoscopic intervention fails or is not possible.Strong recommendation, low quality evidence. 4 ESGE recommends rendezvous EUS techniques over transmural PD drainage in patients with favorable anatomy owing to its lower rate of adverse events.Strong recommendation, low quality evidence. 5 ESGE recommends that, in patients at high surgical risk, EUS-guided gallbladder drainage (GBD) should be favored over percutaneous gallbladder drainage where both techniques are available, owing to the lower rates of adverse events and need for re-interventions in EUS-GBD.Strong recommendation, high quality of evidence. 6 ESGE recommends EUS-guided gastroenterostomy (EUS-GE), in an expert setting, for malignant gastric outlet obstruction, as an alternative to enteral stenting or surgery.Strong recommendation, low quality evidence. 7 ESGE recommends that EUS-GE may be considered in the management of afferent loop syndrome, especially in the setting of malignancy or in poor surgical candidates. Strong recommendation, low quality evidence. 8 ESGE suggests that endoscopic ultrasound-directed transgastric ERCP (EDGE) can be offered, in expert centers, to patients with a Roux-en-Y gastric bypass following multidisciplinary decision-making, with the aim of overcoming the invasiveness of laparoscopy-assisted ERCP and the limitations of enteroscopy-assisted ERCP.Weak recommendation, low quality evidence.

show abstract

Section: Key Question 22: What Are the Technical And Clinical Success Rates Of Edge?mentioning

confidence: 99%

Section: Key Question 20: What Are the Most Common Adverse Events Associated With Eus-ge?mentioning

confidence: 99%

Section: Biliary Drainage In Patients Who Have Undergone Roux-en-y Gastric Bypassmentioning

confidence: 99%

Section: Biliary Drainage In Patients Who Have Undergone Roux-en-y Gastric Bypassmentioning

confidence: 99%

See 2 more Smart Citations

Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

et al. 2021

View full text Add to dashboard Cite

show abstract

“…I read with pleasure the systemic review of Prakash et al on the outcomes, adverse events, and knowledge gaps of endoscopic ultrasound (EUS)-directed transgastric endoscopic retrograde cholangiopancreatography (EDGE) [1]. EDGE was the first example of an EUS-directed entero-enteral anastomosis performed in a human using a lumen-apposing metal stent (LAMS) [2].…”

mentioning

confidence: 99%

Seven years later: do we still have an EDGE?

Kedia

2021

Endoscopy

View full text Add to dashboard Cite

Abdominal Pain After Roux-en-Y Gastric Bypass

Fry,

Finks

2023

JAMA Surg

View full text Add to dashboard Cite

ImportanceRoux-en-Y gastric bypass (RYGB) remains one of the most commonly performed operations for morbid obesity and is associated with significant long-term weight loss and comorbidity remission. However, health care utilization rates following RYGB are high and abdominal pain is reported as the most common presenting symptom for those seeking care.ObservationsGiven the limitations of physical examination in patients with obesity, correct diagnosis of abdominal pain following RYGB depends on a careful history and appropriate use of radiologic, laboratory and endoscopic studies, as well as a clear understanding of post-RYGB anatomy. The most common etiologies of abdominal pain after RYGB are internal hernia, marginal ulcer, biliary disease (eg, cholelithiasis and choledocholithiasis), and jejunojejunal anastomotic issues. Early identification of the etiology of the pain is essential, as some causes, such as internal hernia or perforated gastrojejunal ulcer, may require urgent or emergent intervention to avoid significant morbidity. While laboratory findings and imaging may prove useful, they remain imperfect, and clinical judgment should always be used to determine if surgical exploration is warranted.Conclusions and RelevanceThe etiologies of abdominal pain after RYGB range from the relatively benign to potentially life-threatening. This Review highlights the importance of understanding key anatomical and technical aspects of RYGB to guide appropriate workup, diagnosis, and treatment.

show abstract

Endoscopic ultrasound-directed transgastric ERCP (EDGE): a systematic review describing the outcomes, adverse events, and knowledge gaps

Cited by 45 publications

References 33 publications

Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

Seven years later: do we still have an EDGE?

Abdominal Pain After Roux-en-Y Gastric Bypass

Contact Info

Product

Resources

About