Journal article
Endoscopic approaches to small intestinal strictures
Current opinion in gastroenterology, Vol.39(5), pp.356-361
09/2023
DOI: 10.1097/MOG.0000000000000958
PMID: 37389433
Abstract
Purpose of review Gastric outlet obstruction (GOO) occurs from benign or malignant causes. Historically, the treatment of benign strictures revolved around endoscopic balloon dilation, whereas, in the case of malignant strictures, the placement of self-expandable metallic stents was the focus. The advent of lumen-apposing metal stent has opened new horizons in addressing shortcomings of enteral stenting and surgical gastroenterostomies. The purpose of the review is to discuss the endoscopic approaches to small bowel strictures and to examine the supporting data behind each practice. Recent findings Given the risk and futility of balloon dilation for malignant strictures, enteral stenting is pursued in patients who are poor surgical candidates and with life expectancy less than 6 months. For patients with longer survival, surgical gastroenterostomy (S-GE) should be considered. Recent data have shown comparable technical and clinical success rates between EUS-gastroenterostomy and S-GE but with lower adverse event rate and hospital length of stay. Summary In recurrent benign strictures and malignant GOO, EUS-GE has recently gained momentum in providing an effective and a well tolerated alternative. Individualized therapy centered around the patient's prognosis and preference while factoring in the local expertise for the specific indication is vital.
Details
- Title: Subtitle
- Endoscopic approaches to small intestinal strictures
- Creators
- Munish Ashat - University of IowaRami El-Abiad - University of Iowa Hospitals and ClinicsMouen A. Khashab - Johns Hopkins Hospital
- Resource Type
- Journal article
- Publication Details
- Current opinion in gastroenterology, Vol.39(5), pp.356-361
- DOI
- 10.1097/MOG.0000000000000958
- PMID
- 37389433
- ISSN
- 0267-1379
- eISSN
- 1531-7056
- Language
- English
- Electronic publication date
- 06/23/2023
- Date published
- 09/2023
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984442227402771
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