Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Comparative retrospective outcomes of endoscopic ultrasound-guided gastroenterostomy in patients with gastric outlet obstruction and post-surgical anatomy

  • Michiel Bronswijk (Department of Gastroenterology and Hepatology, University Hospital Gasthuisberg, University of Leuven) ;
  • Jan Clerick (Department of Gastroenterology and Hepatology, University Hospital Gasthuisberg, University of Leuven) ;
  • Giuseppe Vanella (Pancreatobiliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute and University) ;
  • Jayanta Samanta (Department of Gastroenterology, Postgraduate Institute of Medical Education and Research) ;
  • Roy L.J. van Wanrooij (Department of Gastroenterology and Hepatology, Amsterdam UMC, location Vrije Universiteit Amsterdam) ;
  • Schalk Van der Merwe (Department of Gastroenterology and Hepatology, University Hospital Gasthuisberg, University of Leuven)
  • Received : 2025.08.07
  • Accepted : 2025.10.23
  • Published : 2026.05.30
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Abstract

Background/Aims: Data on endoscopic ultrasound (EUS)-guided gastroenterostomy (EUS-GE) are mainly derived from patients with naïve anatomy. This study aimed to evaluate the outcomes of EUS-GE in patients with post-surgical anatomy and compare these findings with those from a cohort of patients with naïve anatomy. Methods: A retrospective tertiary center analysis was performed of consecutive EUS-GE procedures. The wireless-EUS-GE-simplified technique (WEST) was employed for EUS-GE. Clinical success was defined as achieving a postprocedural gastric outlet obstruction scoring system score of ≥2. Results: Overall, 10 patients with post-surgical anatomy and 63 sequential historical controls with naïve anatomy were included from the same time frame (2019-2022). Surgery consisted predominantly of Whipple resection (n=3) or partial gastrectomy (n=2). Clinical success was achieved in 90.0% and 90.5% of patients in the post-surgical and naïve anatomy groups, respectively (p=1.000). Technical success (90.0% vs. 96.8%, p=0.362), median hospital stay (8 vs. 6 days, p=0.397), adverse event rate (10.0% vs. 7.9%, p=1.000), and median follow-up duration (186 vs. 136 days, p=0.303) were comparable between the two groups. However, the median procedure duration was significantly longer in the post-surgical anatomy group compared to that in the naïve group (61 vs. 45 minutes, p=0.037). Conclusions: Although increased technical complexity and a limited sample size should be considered, our comparative data suggest that EUS-GE was equally effective in patients with post-surgical anatomy.

Keywords

References

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