Laparoscopic gastrojejunostomy versus self expanding metal stent for malignant gastric outlet obstruction: a prospective randomised trial

2013 ◽  
Author(s):  
Michael PN Lewis
2018 ◽  
Vol 84 (6) ◽  
pp. 991-995 ◽  
Author(s):  
Shuai Leiyuan ◽  
Xu Jianli ◽  
Zhao Zhengzhong ◽  
Ji Guangyan ◽  
Zhu Dailiang

To compare the clinic outcomes of endoscopic stenting and laparoscopic gastrojejunostomy (LGJ) for patients with malignant gastric outlet obstruction (GOO). We retrospectively reviewed 63 patients with malignant GOO that underwent endoscopic stenting [Stent Group (SG), n = 29] or LGJ [Laparoscopic Group (LG), n = 34]. Then, we evaluated the medical effects, postoperative hospital stay, and hospitalization expenses in both groups. Compared to LG, SG has a shorter operation time [SG: (41.1 ± 9.3) minutes vs LG: (137.4 ± 21.7) minutes, P = 0.000], less intra-operative blood loss [(23.7 ± 9.0) mL vs (121.1 ± 24.3) mL, P = 0.000], relatively lower hospitalization expenses [(2272.7 ± 413.9) $ vs (5182.4 ± 517.3) $, P = 0.000]. Besides, the median intake time was significantly shorter in the SG than that in the LG [(0.9 ± 0.3) days vs (4.1 ± 0.6) days, P = 0.000]. However, there were no significant differences between SG with LG in surgical success rate (100 vs 100%, P = 1.000), length of hospital stay [(6.1 ± 3.3) days vs (10.9 ± 4.7) days, P = 0.422], recurrent obstructive rate (37.9 vs 26.5%, P = 0.949) and median survivals [(141.4 ± 81.4) days vs (122.7 ± 88.8) days, P = 0.879]. Endoscopic stenting and LGJ are both relatively safe and effective treatments for patients with malignant GOO. But we suggest that endoscopic stenting should be considered first in patients with malignant GOO because it has many advantages over LGJ.


2009 ◽  
Vol 69 (5) ◽  
pp. AB380
Author(s):  
Wagner Colaiacovo ◽  
Alaor Caetano ◽  
Denise Guimarães ◽  
Gilberto Fava ◽  
Aldenir Zamboti ◽  
...  

2008 ◽  
Vol 16 (15) ◽  
pp. 1696
Author(s):  
Zhi-Yong Wang ◽  
Li-Wei Sun ◽  
Jian-Liang Wu ◽  
Li Li ◽  
Ju-Mei Ma ◽  
...  

Endoscopy ◽  
2021 ◽  
Author(s):  
Michael Bejjani ◽  
Bachir Ghandour ◽  
Jose Carlos Subtil ◽  
Belén Martínez ◽  
Reem Z Sharaiha ◽  
...  

Background/Aims: The majority of studies on EUS-guided gastroenterostomy (EUS-GE) for palliation of malignant gastric outlet obstruction (GOO) have utilized a 15mm lumen apposing metal stent (LAMS). More recently, a 20mm LAMS has become available. The aim of this study was to compare rates of technical and clinical success, and adverse events (AEs) in patients undergoing EUS-GE using a 20mm vs 15mm LAMS. Methods: Patients who underwent EUS-GE with 15mm or 20mm LAMS for malignant GOO during the period of 1/2018-10/2020 were included. The primary outcome was clinical success, defined as an increase in the gastric outlet obstruction score (GOOS) by at least 1 point during follow-up. Secondary outcomes were technical success, maximum tolerated diet, rate of reintervention, and the rate/severity of AEs. Results: A total of 267 patients (mean age 67yr, F 43%) with malignant GOO from 19 centers underwent EUS-GE. The rate of clinical success was similar between the 15mm and 20mm stents (89.2% [95% CI 84.2-94.2] vs 84.1% [95%CI 77.4-90.6]). However, a significantly higher proportion of patients in the 20mm group tolerated a soft solid/complete diet at the end of follow-up (91.2% [95%CI 84.4-95.7] vs 81.2% [95%CI 73.9-87.2] p=0.04). Overall, AEs occurred in 33 (12.4% [95%CI 8.4-16.3]) patients, with rates being similar between 15mm and 20mm stents (12.8% [95%CI 7.5-18.2] vs 11.8% [95%CI 6-17.6]), including incidence of severe/fatal AEs (2% [95%CI 0.4-5.8] vs 3.4% [95%CI 0.9-8.4]). Conclusions: The 20mm LAMS is similar to the 15mm LAMS in terms of safety and efficacy for patients undergoing EUS-GE for malignant GOO. The 20 mm LAMS allows a more advanced diet and is, thus, the preferred LAMS during EUS-GE.


Sign in / Sign up

Export Citation Format

Share Document