EUS-Directed Transgastric Endoscopic Retrograde Cholangiopancreatography (EDGE): The First Learning Curve.

Journal of Clinical Gastroenterology
Amy TybergMichel Kahaleh

Abstract

Endoscopic ultrasound (EUS)-directed transgastric endoscopic retrograde cholangiopancreatography (EDGE) is a minimally invasive option for pancreaticobiliary access in patients with Roux-en-Y anatomy. The procedure involves creating a fistulous tract between the remnant stomach or jejunum and the bypassed stomach with the deployment of a lumen-apposing metal stent (LAMS), followed by the advancement of an endoscope through the LAMS to perform an ERCP or EUS. It is a technically challenging procedure, requiring skills in EUS, fluoroscopy, and LAMS deployment. The aim of this study was to determine the learning curve for EDGE. Consecutive patients undergoing EDGE by a single operator were included from a prospective registry over 3 years. Demographics, procedure info, postprocedure follow-up data, and adverse events were collected. Nonlinear regression and cumulative sum analyses were conducted for the learning curve. Technical success was defined as the successful creation of the fistulous tract. Clinical success was defined as successful EUS or ERCP via the LAMS. Nineteen patients were included (21% male, mean age 58.7 y). Indication included symptomatic biliary stricture (n=6, 32%), choledocholithiasis (n=5, 26%), pancreatitis...Continue Reading

References

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Citations

Nov 12, 2020·Journal of Clinical Medicine·Se Woo Park, Sang Soo Lee
Dec 24, 2020·Endoscopic Ultrasound·Juan J VilaJuan Carrascosa
Oct 7, 2020·Journal of Clinical Gastroenterology·Nico PaganoAugusto Lauro
Jul 28, 2021·Gastrointestinal Endoscopy·UNKNOWN Prepared by: ASGE TECHNOLOGY COMMITTEEDavid R Lichtenstein

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Methods Mentioned

BETA
gastric bypass

Software Mentioned

EDGE

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