Fluoroscopy-guided gastrojejunostomy: A work in progress
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Surgical gastrojejunostomy (GJ) has traditionally been the mainstay of treatment for malignant gastric outlet obstruction (GOO). However, most patients preferentially choose to undergo self-expandable metal stent (SEMS) placement due to its minimally invasive nature, although it is wellrecognized that surgical GJ is associated with longer patency and less reinterventions than SEMS placement. Endoscopic ultrasound (EUS)-guided GJ has recently emerged as a novel procedure for the treatment of malignant GOO. This procedure offers a non-surgical means of performing GJ, but its widespread use is limited because it could only be performed by experienced endoscopists with expertise in EUS-guided procedures. The authors performed fluoroscopy-guided GJ in eight domestic pigs by puncturing the proximal jejunum from the stomach using a Rösch-Uchida transjugular liver access set followed by the placement of a lumen-apposing metal stent across the puncture tract. The results showed that fluoroscopy-guided GJ may be a technically feasible and simple procedure but, before clinical trials can be undertaken, further technical refinements are required to reduce the risk of inadvertent transgression of non-target organs.
Abstract
Surgical gastrojejunostomy (GJ) has traditionally been the mainstay of treatment for malignant gastric outlet obstruction (GOO). However, most patients preferentially choose to undergo self-expandable metal stent (SEMS) placement due to its minimally invasive nature, although it is wellrecognized that surgical GJ is associated with longer patency and less reinterventions than SEMS placement. Endoscopic ultrasound (EUS)-guided GJ has recently emerged as a novel procedure for the treatment of malignant GOO. This procedure offers a non-surgical means of performing GJ, but its widespread use is limited because it could only be performed by experienced endoscopists with expertise in EUS-guided procedures. The authors performed fluoroscopy-guided GJ in eight domestic pigs by puncturing the proximal jejunum from the stomach using a Rösch-Uchida transjugular liver access set followed by the placement of a lumen-apposing metal stent across the puncture tract. The results showed that fluoroscopy-guided GJ may be a technically feasible and simple procedure but, before clinical trials can be undertaken, further technical refinements are required to reduce the risk of inadvertent transgression of non-target organs.
참고문헌 (13)
- Lopera JE, "Gastroduodenal stent placement: current status", Radiographics, 24, pp.1561~1573 (2004)
- Jeurnink SM, "Gastrojejunostomy versus stent placement in patients with malignant gastric outlet obstruction: a comparison in 95 patients", J Surg Oncol, 96, pp.389~396 (2007)
- Jeurnink SM, "Surgical gastrojejunostomy or endoscopic stent placement for the palliation of malignant gastric outlet obstruction (SUSTENT study): a multicenter randomized trial", Gastrointest Endosc, 71, pp.490~499 (2010)
- No JH, "Long-term outcome of palliative therapy for gastric outlet obstruction caused by unresectable gastric cancer in patients with good performance status: endoscopic stenting versus surgery", Gastrointest Endosc, 78, pp.55~62 (2013)
- Park CH, "Impact of carcinomatosis and ascites status on long-term outcomes of palliative treatment for patients with gastric outlet obstruction caused by unresectable gastric cancer: stent placement versus palliative gastrojejunostomy", Gastrointest Endosc, 81, pp.321~332 (2015)
- Park JH, "Over-the-wire versus through-the-scope stents for the palliation of malignant gastric outlet obstruction:a retrospective comparison study", Eur Radiol, 26, pp.4249~4258 (2016)
- Kim JH, "Metallic stent placement in the palliative treatment of malignant gastroduodenal obstructions: prospective evaluation of results and factors influencing outcome in 213 patients", Gastrointest Endosc, 66, pp.256~264 (2007)
- Tyberg A, "Endoscopic ultrasound-guided gastrojejunostomy with a lumen-apposing metal stent: a multicenter, international experience", Endosc Int Open, 4, pp.E276~E281 (2016)
- Li J, "Fluoroscopy-guided gastrojejunostomy creation with lumen-apposing metal stent in a porcine model", Cardiovasc Intervent Radiol, 43, pp.1687~1694 (2020)
- Kaminou T, "Percutaneous retroperitoneal splenorenal shunt: an experimental study in swine", Radiology, 206, pp.799~802 (1998)
- Itoi T, "Technical review of endoscopic ultrasonography-guided gastroenterostomy in 2017", Dig Endosc, 29, pp.495~502 (2017)
- Itoi T, "Prospective evaluation of endoscopic ultrasonography-guided double-balloon-occluded gastrojejunostomy bypass (EPASS) for malignant gastric outlet obstruction", Gut, 65, pp.193~195 (2016)
- Pham KD, "Endoscopic management of gastrocolic fistula after endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ)", Endoscopy, 51, pp.E169~ (2019)