EUS-Guided Gastroenterostomy: Balloon Technique

Abstract

Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a novel approach in the management of malignant gastric outlet obstruction that has gained attention with the advent of the lumen apposing metal stent (LAMS) [1]. EUS-GE allows for a luminal bypass of the tumor obstruction, which has been shown to decrease the risk for stent dysfunction and re-intervention when compared to traditional enteral stenting. In addition, the endoscopic approach avoids the morbidity of surgery and has been shown to be similar in safety as enteral stenting [2]. Various techniques have been described to perform EUS-GE including the direct technique and endoscopic ultrasonography-guided double-balloon-occluded gastrojejunostomy bypass (EPASS). The following describes the balloon-assisted gastroenteromy (BAGE) method, which is one of the first described techniques for EUS-GE.