RECENT DEVELOPMENT
Endoscopic ultrasonography (EUS)-guided gastroenterostomy (EUS-GE)
Gastric outlet obstruction (GOO) can be caused by various benign and malignant diseases. GOO, impair quality of life substantially, and have detrimental effects on nutrition because of nause and/or vomiting. Classically, patients with a malignant gastric outlet obstruction were treated with a surgical procedure, such as a gastrojejunostomy (creating a connection between stomach and intestine). Surgical intervention is invasive, and is associated with significant morbidity especially in very sick patients with multiple co-morbid diseases. Endoscopic placement of a permanent, endoluminal, self-expandable metal stent (SEMS) is an alternative method, but have a risk of closure in long-term.
Recently, endoscopic ultrasonography (EUS)-guided gastroenterostomy (EUS-GE) has emerged as a new therapeutic modality for patients with GOO. EUS-GE is a minimally invasive endoscopic techniques to relieve GOO. Growing data has now demonstrated feasibility, good luminal patency and high clinical success.The logic behind endoscopic ultrasonography (EUS)-guided gastroenterostomy is to anastomose stomach to a loop of the small bowel under endoscopic ultrasound guidance and using a lumen-apposing metal stent. This approach replicates a surgical anastomosis while taking advantage of minimal invasiveness supplied by endoscopy.