Citations 2
US multicenter outcomes of endoscopic ultrasound-guided gallbladder drainage with lumen-apposing metal stents for acute cholecystitis
David, Yakira , Kakked, Gaurav, Confer, Bradley , Shah, Ruchit N. , Khara, Harshit S. , Diehl, David L. , Krafft, Matthew , Shah-Khan, Sardar M. , Nasr, John , Benias, Petros C. , Muniraj, Thiruvengadam , Aslanian, Harry R., Chahal, Prabhleen , Rodriguez, John , DuBroff, Jason, Latour, Rabi De, Khanna, Lauren , Haber, Gregory , Hoerter, Nicholas A. , Pandey, Nishi , Bakhit, Mena , Kowalski, Thomas E., Loren, David E. , Chiang, Austin , Schlachterman, Alexander , Nieto, Jose , Ichkhanian, Yervant , Khashab, Mouen A. , Halabi, Maan El , Kwon, Richard S. , Hernandez-Lara, Ariosto, Poneros, John M., Sethi, Amrita, Gonda, Tamas A. , Kushnir, Vladimir , Cosgrove, Natalie , Mullady, Daniel , Al-Shahrani, Abdullah , Buscaglia, Jonathan M. , Bucobo, Juan Carlos , Rolston, Vineet S. , Kedia, Prashant , Kasmin, Franklin, Kumta, Nikhil A. , DiMaio, Christopher J. , Krafft, Matthew Richard , Trindade, Arvind J. , Adler, Douglas G. , Tzimas, Demetrios J. , Goodman, Adam J. , Nieto, José , Deshmukh, Ameya A. , Prabhu, Anoop , Storm, Andrew C. , Berzin, Tyler M. , Sethi, Amrita , D'Souza, Lionel S. , Nagula, Satish
Endoscopy International Open | January 13, 2025 | Volume: 13 | Issue: CP | Pages: No page available
AbstractEUS-guided gallbladder drainage (EUS-GBD) using lumen apposing metal stents (LAMS) has excellent technical and short-term clinical success for acute cholecystitis (AC). The goals of this study were to determine the long-term clinical outcomes and adverse events (AEs) of EUS-GBD with LAMS.A multicenter, retrospective study was conducted at 18 US tertiary care institutions. Inclusion criteria: any AC patient with attempted EUS-GBD with LAMS and minimum 30-day post-procedure follow-up. Long-term clinical success was defined as absence of recurrent acute cholecystitis (RAC) > 30 days and long-term AE was defined as occurring > 30 days from the index procedure.A total of 109 patients were included. Technical success was achieved in 108 of 109 (99.1%) and initial clinical success in 106 of 109 (97.2%). Long-term clinical success was achieved in 98 of 109 (89.9%) over a median follow-up of 140 days (range 30–1188). On multivariable analysis (MVA), acalculous cholecystitis (odds ratio [OR] 15.93, 95% confidence interval [CI] 1.22–208.52, P = 0.04) and the occurrence of a LAMS-specific AE (OR 63.60, 95% CI 5.08–799.29, P <0.01) were associated with RAC. AEs occurred in 38 of 109 patients (34.9%) at any time, and in 10 of 109 (9.17%) > 30 days from the index procedure. Most long-term AEs (7 of 109; 6.42%) were LAMS-specific. No technical or clinical factors were associated with occurrence of AEs. LAMS were removed in 24 of 109 patients (22%). There was no difference in RAC or AEs whether LAMS was removed or not.EUS-GBD with LAMS has a high rate of long-term clinical success and modest AE rates in patients with AC and is a reasonable destination therapy for high-risk surgical candidates.
Revisional Procedures after Sleeve Gastrectomy for Weight Recurrence or Inadequate Weight Loss: An Analysis of the MBSAQIP Database
Hage, Karl , Romero-Vélez, Gustavo , Allemang, Matthew T. , Navarrete, Salvador , Rodriguez, John , Ghanem, Omar M. , Kroh, Matthew , Dang, Jerry T. , Romero-Velez, Gustavo , Dang, Jerry T , Barajas-Gamboa, Juan Sebastian , Corcelles, Ricard
Journal of Clinical Medicine | September 15, 2023 | Volume: 12 | Issue: 18 | Pages: 5975
Introduction: The safety of conversional bariatric procedures after sleeve gastrectomy (SG) for weight recurrence (WR) or inadequate weight loss (IWL) is debated due to limited evidence. Conversion options include Roux-en-Y gastric bypass (RYGB), single anastomosis duodeno-ileal bypass (SADI), and biliopancreatic diversion with duodenal switch (BPD-DS). We aimed to compare serious complications and mortality rates between these procedures within 30 days. Methods: Using the 2020 and 2021 MBSAQIP databases, we identified patients who underwent a conversion from SG to RYGB, SADI, or BPD-DS. We performed a multivariable logistic regression to assess predictors of 30-day complications and mortality. Results: Among 7388 patients (77.6% RYGB, 8.7% SADI, 13.7% BPD-DS), those undergoing SADI and BPD-DS had higher preoperative body mass index. Conversion reasons included WR (63.0%) and IWL (37.0%). SADI and BPD-DS patients had longer operative times (p < 0.001) and higher leak rates (p = 0.001). Serious complications, reoperations, readmissions, and 30-day mortality were similar across groups. Conversion procedure type was not an independent predictor of complications. Conclusion: RYGB was the most performed conversional procedure after SG. The study indicated a similar safety profile for revisional RYGB, SADI, and BPD-DS, with comparable 30-day complications and mortality rates. However, SADI and BPD-DS patients had longer operative time and higher leak rates.