{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T04:03:34Z","timestamp":1771905814859,"version":"3.50.1"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T00:00:00Z","timestamp":1652400000000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) is an endoscopic procedure for treating gastric outlet obstruction (GOO). Limited data exist regarding the safety and efficacy of EUS-GJ in patients with malignant GOO with ascites. Thus, we aimed to study the outcomes and safety of EUS-GJ in GOO patients with vs. without ascites.<\/jats:p><jats:p>\n          Patients and methods\u2002This is a retrospective cohort study of patients with malignant GOO who underwent successful EUS-GJ at a tertiary care academic center. Primary outcomes included the efficacy and safety of EUS-GJ. Secondary outcomes included 30-day readmission, reintervention, and survival utilizing Kaplan-Meier analysis.<\/jats:p><jats:p>\n          Results\u2002A total of 55 patients (mean age of 67.0\u200a\u00b1\u200a11.3 years, 40.0\u200a% female) who underwent EUS-GJ, of whom 24 had ascites (small in 22, large in 2) were included. Clinical success was achieved in 91.7\u200a% and 93.5\u200a% (P\u200a=\u200a1.00) of patients with and without ascites, respectively. A higher rate of adverse events (AEs) was noted in patients with ascites but this was not statistically significant (37.5\u200a% vs. 19.4\u200a%, P\u200a=\u200a0.13). Four patients in the ascites group (16.6\u200a%) developed clinical evidence of peritonitis or sepsis post-EUS-GJ. Eight patients with ascites developed worsening ascites within a month of EUS-GJ. In contrast, only one patient without ascites developed evidence of new ascites. The median survival of patients was not significantly different between the two groups (patients with ascites: 129 days vs. patients without ascites: 180 days, (P\u200a=\u200a0.12).<\/jats:p><jats:p>\n          Conclusions\u2002The efficacy EUS-GJ in the presence of ascites is promising; however, the safety profile remains concerning given the high rate of AEs, specifically peritonitis and sepsis.<\/jats:p>","DOI":"10.1055\/a-1797-9318","type":"journal-article","created":{"date-parts":[[2022,5,13]],"date-time":"2022-05-13T22:30:15Z","timestamp":1652481015000},"page":"E670-E678","source":"Crossref","is-referenced-by-count":10,"title":["Efficacy and safety of endoscopic ultrasound-guided gastrojejunostomy in patients with malignant gastric outlet obstruction and ascites"],"prefix":"10.1055","volume":"10","author":[{"given":"Tala","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew C.","family":"Storm","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan J.","family":"Law","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veeravich","family":"Jaruvongvanich","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabih","family":"Ghazi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rami","family":"Abusaleh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric J.","family":"Vargas","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fateh","family":"Bazerbachi","sequence":"additional","affiliation":[{"name":"Interventional Endoscopy Program, CentraCare Digestive Center, St. Cloud Hospital, St. Cloud, Minnesota, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Levy","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark J.","family":"Truty","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinay","family":"Chandrasekhara","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barham K.","family":"Abu Dayyeh","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,5,13]]},"reference":[{"key":"ref1","first-page":"171","article-title":"Palliative treatment in \"peri\"-pancreatic carcinoma: stenting or surgical 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malignant gastric outlet obstruction","volume":"5","author":"M A Khashab","year":"2017","journal-title":"Endosc Int Open"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"E363","DOI":"10.1055\/s-0043-123468","article-title":"EUS-guided gastroenterostomy in management of benign gastric outlet obstruction","volume":"6","author":"Y I Chen","year":"2018","journal-title":"Endosc Int Open"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"E276","DOI":"10.1055\/s-0042-101789","article-title":"Endoscopic ultrasound-guided gastrojejunostomy with a lumen-apposing metal stent: a multicenter, international experience","volume":"4","author":"A Tyberg","year":"2016","journal-title":"Endosc Int Open"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"E1194","DOI":"10.1055\/a-1214-5659","article-title":"Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction","volume":"8","author":"J B Kastelijn","year":"2020","journal-title":"Endosc Int Open"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"E1455","DOI":"10.1055\/a-1231-5011","article-title":"Malignant GOO: Are duodenal stenting and surgical gastrojejunostomy obsolete?","volume":"8","author":"M G Keane","year":"2020","journal-title":"Endosc Int Open"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"93","DOI":"10.21037\/tgh.2018.11.03","article-title":"Endoscopic ultrasound guided gastrojejunostomy","volume":"3","author":"E Dawod","year":"2018","journal-title":"Translat Gastroenterol Hepatol"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/j.1572-0241.2002.05423.x","article-title":"Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients","volume":"97","author":"D G Adler","year":"2002","journal-title":"Am J 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malignant gastric outlet obstruction","volume":"31","author":"Y I Chen","year":"2017","journal-title":"Surg Endosc"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"3404","DOI":"10.1007\/s00464-018-06636-3","article-title":"EUS-guided gastroenterostomy versus enteral stent placement for palliation of malignant gastric outlet obstruction","volume":"33","author":"P S Ge","year":"2019","journal-title":"Surg Endosc"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"E144","DOI":"10.1055\/a-0799-9939","article-title":"Durability and long-term outcomes of direct EUS-guided gastroenterostomy using lumen-apposing metal stents for gastric outlet obstruction","volume":"7","author":"T Kerdsirichairat","year":"2019","journal-title":"Endosc Int Open"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"E1918","DOI":"10.1055\/a-1642-7892","article-title":"Gastric outlet obstruction with ascites: EUS-guided gastro-enterostomy is feasible","volume":"9","author":"J Basha","year":"2021","journal-title":"Endosc Int Open"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/j.gie.2015.06.017","article-title":"EUS-guided gastroenterostomy: the first U.S. clinical experience (with video)","volume":"82","author":"M A Khashab","year":"2015","journal-title":"Gastrointest Endosc"}],"container-title":["Endoscopy International 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