RÉSUMÉ
Gastric outlet obstruction,also known as pyloric obstruction or stenosis,refers to pyloric stenosis caused by mechanical compression or obstruction of the duodenum,distal stomach,pyloric duct,and anterior pyloric region.Patients will have the phenomenon that gastric contents cannot pass,accompanied by nausea,vomiting,abdominal pain,and loss of appetite and other related symptoms,which greatly reduces the quality of life of patients,has a wide range of individual impact,and has a high degree of harm.Scientific treatment of this disease has extremely important social significance.Based on the pathogenesis,clinical diagnosis and treatment strategies of gastric outlet obstruction,this article will make a certain summary for the diagnosis and treatment of gastric outlet obstruction for reference.
RÉSUMÉ
Objective:To evaluate the safety and feasibility of double endoscopic bypass, namely endoscopic ultrasound-guided gastroenterostomy (EUS-GE) combined with endoscopic ultrasound-guided biliary drainage (EUS-BD), for malignant gastric outlet and biliary obstruction.Methods:A retrospective analysis was conducted on data of 10 patients with malignant gastric outlet and biliary obstruction who were not suitable for surgery or endoscopic retrograde cholangiopancreatography (ERCP) and treated by double endoscopic bypass in Nanjing Drum Tower Hospital from August 2017 to October 2020. The completion of therapy, clinical efficacy and post-procedure adverse events were analyzed.Results:Ten patients with different malignant cancer successfully underwent EUS-GE and EUS-BD, with procedure time of 60.5±22.3 min (30-100 min). There were no postoperative adverse events. EUS-GE was clinically successful in all 10 cases. Of the 10 EUS-BD cases, 9 were clinically successful, and 1 did not meet the criteria of clinical success. The median follow-up was 71 (37-120) days. None of the 10 patients had recurrent gastric outflow tract obstruction or biliary tract obstruction.Conclusion:Double endoscopic bypass is feasible and effective for patients with malignant gastric outlet and biliary obstruction and without surgery or ERCP opportunity.