Evidence map›Paper›PMID 33909126›Full record

ArticleSurgical endoscopy2022

EUS-guided hepaticogastrostomy for patients with afferent loop syndrome: a comparison with EUS-guided gastroenterostomy or percutaneous drainage.

Charlotte De Bie, Michiel Bronswijk, Giuseppe Vanella, Enrique Pérez-Cuadrado-Robles, Hannah van Malenstein, Wim Laleman, Schalk Van der Merwe

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In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 3 countries.

Charlotte De BieDepartment of Gastroenterology and Hepatology, University Hospitals Gasthuisberg, University of Leuven, Herestraat 49, 3000, Leuven, Belgium.
Michiel BronswijkDepartment of Gastroenterology and Hepatology, University Hospitals Gasthuisberg, University of Leuven, Herestraat 49, 3000, Leuven, Belgium. michiel.bronswijk@uzleuven.be.ORCID 0000-0003-2039-5022
Giuseppe VanellaDepartment of Gastroenterology and Hepatology, University Hospitals Gasthuisberg, University of Leuven, Herestraat 49, 3000, Leuven, Belgium.
Enrique Pérez-Cuadrado-RoblesGastroenterology and Digestive Endoscopy Department, Georges Pompidou European Hospital, Paris, France.
Hannah van MalensteinDepartment of Gastroenterology and Hepatology, University Hospitals Gasthuisberg, University of Leuven, Herestraat 49, 3000, Leuven, Belgium.
Wim LalemanDepartment of Gastroenterology and Hepatology, University Hospitals Gasthuisberg, University of Leuven, Herestraat 49, 3000, Leuven, Belgium.
Schalk Van der MerweDepartment of Gastroenterology and Hepatology, University Hospitals Gasthuisberg, University of Leuven, Herestraat 49, 3000, Leuven, Belgium.
KU Leuven · BEHôpital Européen Georges-Pompidou · FRUniversitair Ziekenhuis Leuven · BEVita-Salute San Raffaele University · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWhere palliative surgery or percutaneous drainage used to be the only option in patients with afferent loop syndrome, endoscopic management by EUS-guided gastroenterostomy has been gaining ground. However, EUS-guided hepaticogastrostomy might also provide sufficient biliary drainage. Our aim was to evaluate the feasibility of EUS-guided hepaticogastrostomy for the management of afferent loop syndrome and provide comparative data on the different approaches.

methodsThe institutional databases were queried for all consecutive minimally invasive procedures for afferent loop syndrome. A retrospective, dual-centre analysis was performed, separately analysing EUS-guided hepaticogastrostomy, EUS-guided gastroenterostomy and percutaneous drainage. Efficacy, safety, need for re-intervention, hospital stay and overall survival were compared.

resultsIn total, 17 patients were included (mean age 59 years (± SD 10.5), 23.5% female). Six patients, which were ineligible for EUS-guided gastroenterostomy, were treated with EUS-guided hepaticogastrostomy. EUS-guided gastroenterostomy and percutaneous drainage were performed in 6 and 5 patients respectively. Clinical success was achieved in all EUS-treated patients, versus 80% in the percutaneous drainage group (p = 0.455). Furthermore, higher rates of bilirubin decrease were seen among patients undergoing EUS: > 25% bilirubin decrease in 10 vs. 1 patient(s) in the percutaneously drained group (p = 0.028), with > 50% and > 75% decrease identified only in the EUS group. Using the ASGE lexicon for adverse event grading, adverse events occurred only in patients treated with percutaneous drainage (60%, p = 0.015). And last, the median number of re-interventions was significantly lower in patients undergoing EUS (0 (IQR 0.0-1.0) vs. 1 (0.5-2.5), p = 0.045) when compared to percutaneous drainage.

conclusionsIn the management of afferent loop syndrome, EUS seems to outperform percutaneous drainage. Moreover, in our cohort, EUS-guided gastroenterostomy and hepaticogastrostomy provided similar outcomes, suggesting EUS-guided hepaticogastrostomy as the salvage procedure in situations where EUS-guided gastroenterostomy is not feasible or has failed.

Indexed as

Afferent Loop SyndromeCholestasisBilirubinCholangiopancreatography, Endoscopic RetrogradeDrainageEndosonographyFemaleGastroenterostomyHumansMaleMiddle AgedRetrospective StudiesStentsBilirubinAfferent loop syndromeEndoscopic ultrasoundGastroenterostomyHepaticogastrostomyPTC

Identifiers

PMID33909126
OpenAlexW3158747809

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.