{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T21:42:33Z","timestamp":1740174153798,"version":"3.37.3"},"reference-count":7,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T00:00:00Z","timestamp":1733702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Gastric access temporary for endoscopy (GATE) via endoscopic ultrasound-guided stent placement between the gastric pouch\/jejunum and remnant stomach is used in Roux-en-Y gastric bypass (RYGB) to facilitate endoscopic retrograde cholangiopancreatography or other maneuvers. This study aimed to identify radiographic predictors of GATE failure and intraprocedure reasons for aborting.<\/jats:p><jats:p>Patients undergoing GATE were matched 3:1 on procedure success. Features indicating quality of the transgastric window were collected including: 1) gastric pouch\/blind limb length; 2) location of remnant stomach relative to pouch or blind\/roux limb; 3) pouch orientation; 4) remnant orientation; 5) length of contact; 6) tissue thickness; and 7) presence of poor contact (calcification, surgical material, intervening vasculature). Primary outcome was radiographic criteria associated with GATE failure. Secondary outcomes were endoscopic, endosonographic, and fluoroscopic intraprocedure reasons for aborting GATE.<\/jats:p><jats:p>Forty patients (30 successful, 10 aborted, 82.5% female) who underwent GATE were\n        included. Mean (\u00b1SD) age and time since RYGB were 62.8\u00b111.9 and 15.1\u00b18.6 years,\n        respectively. There were no group demographic differences. The cumulative number of\n        contact-related risk factors was associated with GATE failure (OR 26.1, 95% CI 0.004\u20130.337;\n          P=0.004). Two or more factors increased the likelihood of GATE\n        failure (P &lt;0.05). Echoendoscope angulation\/tip deflection,\n        intervening vasculature, distance to remnant stomach, rapid emptying and\/or insufficient\n        filling of contrast were reported in cases of GATE failure.<\/jats:p><jats:p>Radiographic features may predict GATE failure including intervening vasculature or insufficient contact between gastric pouch\/blind limb and remnant. Patients demonstrating these features may benefit from alternative treatment approaches early in management.<\/jats:p>","DOI":"10.1055\/a-2499-3468","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:16:46Z","timestamp":1733789806000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Radiographic, fluoroscopic, and endosonographic predictors of failed EUS-guided transgastric stent placement in patients with Roux-en-Y bypass anatomy"],"prefix":"10.1055","volume":"13","author":[{"given":"Benjamin M","family":"Moy","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hero","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Michigan, Ann Arbor, Michigan, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6933-0791","authenticated-orcid":false,"given":"Jessica X","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin D","family":"Platt","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge D","family":"Machicado","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard S","family":"Kwon","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik-Jan","family":"Wamsteker","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George M","family":"Philips","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison R","family":"Schulman","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, United States"},{"name":"Department of Surgery, University of Michigan, Ann Arbor, Michigan, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"2921","DOI":"10.1007\/s00261-015-0532-7","article-title":"Endoscopic retrograde cholangiopancreatography in patients with surgically altered gastrointestinal anatomy","volume":"40","author":"S Amer","year":"2015","journal-title":"Abdom Imaging"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2715","DOI":"10.3748\/wjg.v26.i21.2715","article-title":"Alternative uses of lumen apposing metal stents","volume":"26","author":"P Sharma","year":"2020","journal-title":"World J Gastroenterol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"E529","DOI":"10.1055\/a-2057-5984","article-title":"Endoscopic ultrasound-directed transgastric ERCP (EDGE): A multicenter US study on long-term follow-up and fistula closure","volume":"11","author":"P Kedia","year":"2023","journal-title":"Endosc Int Open"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"185","DOI":"10.5946\/ce.2016.030","article-title":"Endoscopic ultrasound (EUS)-directed transgastric endoscopic retrograde cholangiopancreatography or EUS: Mid-term analysis of an emerging procedure","volume":"50","author":"A Tyberg","year":"2017","journal-title":"Clin Endosc"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1055\/s-0043-105072","article-title":"Endoscopic ultrasound-guided creation of a transgastric fistula for the management of hepatobiliary disease in patients with Roux-en-Y gastric bypass","volume":"49","author":"S Ngamruengphong","year":"2017","journal-title":"Endoscopy"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2024","DOI":"10.1007\/s00464-019-06715-z","article-title":"Gastric access temporary for endoscopy (GATE): a proposed algorithm for EUS-directed transgastric ERCP in gastric bypass patients","volume":"33","author":"TJ Wang","year":"2019","journal-title":"Surg Endosc"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1007\/s11894-021-00808-3","article-title":"Review of ERCP techniques in Roux-en-Y gastric bypass patients: Highlight on the novel EUS-directed transgastric ERCP (EGDE) technique","volume":"23","author":"HS Khara","year":"2021","journal-title":"Curr Gastroenterol Rep"}],"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2499-3468.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T23:59:06Z","timestamp":1738195146000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2499-3468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,9]]},"references-count":7,"journal-issue":{"issue":"CP","published-online":{"date-parts":[[2025,1,7]]},"published-print":{"date-parts":[[2025]]}},"alternative-id":["a24993468"],"URL":"https:\/\/doi.org\/10.1055\/a-2499-3468","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"type":"print","value":"2364-3722"},{"type":"electronic","value":"2196-9736"}],"subject":[],"published-other":{"date-parts":[[2024,12,9]]},"published":{"date-parts":[[2024,12,9]]}}}