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. 2025 Mar 6;17(5):910.
doi: 10.3390/cancers17050910.

Endoscopic Ultrasound-Guided Anastomoses of the Gastrointestinal Tract: A Multicentric Experience

Giacomo Emanuele Maria Rizzo  1   2 , Chiara Coluccio  3 , Edoardo Forti  4 , Alessandro Fugazza  5 , Cecilia Binda  3 , Giuseppe Vanella  6 , Francesco Maria Di Matteo  7 , Stefano Francesco Crinò  8 , Andrea Lisotti  9 , Marcello Fabio Maida  10 , Giovanni Aragona  11 , Aurelio Mauro  12 , Alessandro Repici  5 , Andrea Anderloni  12   13 , Carlo Fabbri  3 , Ilaria Tarantino  1 , On Behalf Of The I-Eus Group
Affiliations

Endoscopic Ultrasound-Guided Anastomoses of the Gastrointestinal Tract: A Multicentric Experience

Giacomo Emanuele Maria Rizzo et al. Cancers (Basel). .

Abstract

This multicenter retrospective study included patients undergoing EUS-guided GI anastomoses from 2016 to 2023. Indications for EUS-guided anastomosis were GOO, ALS or patients with altered anatomy needing endoscopic interventions. The primary outcome was technical success, while secondary outcomes included clinical success, safety, lumen-apposing metal stent (LAMS) patency, and the need for reinterventions. A total of 216 patients (mean age 64.5 [±13.94] years; 49.1% males) were included. In total, 149 cases (69%) were GOO, 44 (20.4%) cases were bilioenteric anastomotic strictures or lithiasis in altered anatomy, 14 cases (6.5%) were ALS, and 9 patients (4.2%) were for ERCP in altered anatomy after EUS-GG. Overall, EUS-GE was performed in 181 patients (83.8%), EUS-JJ in 44 cases (20.4%), and EUS-GG in 10 (4.6%). Technical success was 94.91%, and clinical success was 93.66%. The adverse event (AE) rate was 11.1%. The reintervention rate was 7.69%. The median follow-up was 85 days. In conclusions, EUS-guided GI anastomoses are technically feasible and safe in both malignant and benign diseases.

Keywords: afferent limb syndrome; endoscopic ultrasound; endoscopy; gastric outlet obstruction; gastroenteroanastomosis.

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Conflict of interest statement

Alessandro Fugazza is a consultant for Boston Scientific. Andrea Lisotti has a contract of proctorship for 2021–2024 with Boston Scientific Corporation. Chiara Coluccio is a lecturer for Steris. Cecilia Binda received lecturer fees for Fujifilm, Steris, Q3 Medical, Boston Scientific. Carlo Fabbri is a consultant for Boston Scientific, Lecturer for Steris and Q3 Medical. All the other authors declare no conflicts of interest. All authors have read and approved the manuscript.

Figures

Figure 1
Figure 1
(A) Endoscopic ultrasound (EUS) view of lumen-apposing metal stent (LAMS) system deployment with distal tip into the jejunal lumen (white arrow) and distal flange released into the jejunum (red arrow). (B) Endoscopic view of proximal flange of LAMS into the gastric cavity when LAMS is not dilated. (C) Endoscopic view of a gastrojejunostomy (GJ) after dilation of the LAMS; white arrow indicates jejunal lumen and red arrow indicates proximal flange of the LAMS. (D) Radiologic evaluation of the GJ showing contrast dye in the stomach (white arrow) flowing through the LAMS (red arrow) into the jejunum (black arrow).
Figure 2
Figure 2
Graphical representation of EUS-guided gastroenterostomy: (A) EUS-guided jejunojejunostomy, (B), and (C) EUS-guided gastrogastrostomy.
See this image and copyright information in PMC

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