Retrievable Anchor-Assisted Endoscopic Ultrasound guided Gastroenterostomy for Diverse Clinical Scenarios of Upper Gastrointestinal Obstruction: A Pilot Feasibility Study.

BACKGROUND AND AIMS: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a promising treatment for gastric outlet obstruction (GOO), but is technically challenging. This study aimed to evaluate the safety and effectiveness of a novel technique, retrievable anchor-assisted EUS-GE (AA-EUS-GE). METHODS: In this pilot feasibility study, patients with benign or malignant GOO underwent AA-EUS-GE using a retrievable anchor system and an electrocautery-enhanced lumen-apposing metal stent. The primary outcomes were technical and clinical (tolerance of solid diet within one week post-procedure) success rates. RESULTS: Twelve patients were enrolled (August 2023 to February 2025). Both technical and clinical success rates were 100%. The median procedure time was 30 minutes. All patients resumed liquid intake by day 2, soft diets by day 3, and regular diets within 7 days. No procedure-related serious adverse events occurred. CONCLUSIONS: In this cohort, AA-EUS-GE demonstrated excellent feasibility and safety, achieving a very high success rate without serious complications.