Efficacy of direct versus double-balloon occlusion techniques in endoscopic ultrasound-guided gastroenterostomy for gastric outlet obstruction: a retrospective cohort study (with video)
10.3760/cma.j.cn321463-20241112-00517
- VernacularTitle:超声内镜引导胃肠吻合术直接法和双气囊封堵法治疗胃流出道梗阻疗效对比的回顾性队列研究（含视频）
- Author:
Zhaorong WU
1
;
Wei ZHAN
;
Wenting LI
;
Tian TIAN
;
Qin YIN
;
Shanshan SHEN
;
Lei WANG
;
Wen LI
Author Information
1. 南京中医药大学，南京 210023
- Publication Type:Journal Article
- Keywords:
Gastric outlet obstruction;
Endoscopic ultrasound-guided gastroenterostomy;
Curative effect;
Direct technique;
Double-balloon occlusion technique
- From:
Chinese Journal of Digestive Endoscopy
2025;42(11):864-870
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacy of direct versus double-balloon occlusion in endoscopic ultrasound-guided gastroenterostomy (EUS-GE) for benign and malignant gastric outlet obstruction (GOO).Methods:Clinical data of patients with GOO who underwent EUS-GE at Nanjing Drum Tower Hospital between April 2017 and July 2024 were analyzed in a retrospectively cohort study. The patients were divided into the direct technique group ( n=36) and the double-balloon occlusion technique group ( n=105). The technical success rate, clinical success rate, procedure time, postoperative stay, stent replacement rate, and incidence of adverse events were compared between the two groups. Results:The technical success rates of the two groups were comparable, 97.2% (35/36) and 94.3% (99/105) ( χ2=0.065, P=0.798), so were the clinical success rates, 94.4% (34/36) and 86.7% (91/105) ( χ2=0.932, P=0.334). However, the direct technique group demonstrated significantly shorter procedure time and postoperative stay compared to the double-balloon occlusion group [33.4 (23.2, 42.3) min VS 43.4 (31.7, 63.1) min, Z=-3.057, P=0.002; 4.0 (3.00, 5.75) days VS 6.0 (5.00, 9.00) days, Z=-4.031, P<0.001]. Adverse event rates [11.1% (4/36) VS 11.4% (12/105), χ2<0.001, P=1.000] and stent replacement rates [5.6% (2/36) VS 9.5% (10/105), χ2=0.152, P=0.696] showed no significant differences. Conclusion:Both EUS-GE techniques achieve comparable efficacy and safety for GOO. However, the direct technique showed significant advantages over the double-balloon occlusion technique in terms of shorter procedure time and reduced postoperative hospital stay.
