ArticleiGIE : innovation, investigation and insights2025
Endoscopic ultrasound-guided gastroenterostomy for managing gastroparesis refractory to gastric peroral endoscopic pylorotomy: a promising new therapeutic option.
Article in iGIE : innovation, investigation and insights, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors.
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Abstract
Background and Aims: Gastric peroral endoscopic myotomy (G-POEM) reaches an efficacy rate around 65% for gastroparesis. Endoscopic ultrasound (EUS)-guided gastroenteroanastomosis (EUS-GEA) has demonstrated efficacy in gastric outlet obstruction. We evaluated it for refractory gastroparesis. Methods: We undertook a single-center retrospective study enrolling patients with gastroparesis treated with G-POEM with failure or symptoms recurrence managed with EUS-GEA. The drain-assisted EUS-GEA technique with 20-mm lumen-apposing stent was applied. End points were clinical efficacy at 6 months, adverse events, and recurrence rate. Results: Twelve patients were included, median age 46 years (interquartile range [IQR], 16-78 y). Patients had an abnormal gastric emptying or bezoar, and 50% never improved from baseline. Median follow-up was 11.5 months (IQR, 6-26 mo). Clinical efficacy rate was 75% at 6 months. The median preoperative Gastroparesis Cardinal Symptoms Index was 4.1 (IQR, 1.6-5) versus 1.6 (IQR, 0-2.6; Conclusions: EUS-GEA demonstrated promising results in improving patients with gastroparesis refractory to G-POEM. Prospective evaluation is required to confirm these results.
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