Modified endoscopic ultrasound-guided double-balloon-occluded gastroenterostomy bypass (M-EPASS): A pilot study

Amanda Marino, Ali Bessissow, Corey Miller, David Valenti, Louis Boucher, Prosanto Chaudhury, Jeffrey Barkun, Nauzer Forbes, Mouen A. Khashab, Myriam Martel, Yen I. Chen

Research output: Contribution to journalArticlepeer-review


Introduction We recently developed a double-balloon device, using widely available existing technology, to facilitate endoscopic ultrasound-guided gastroenterostomy (EUS-GE). Our aim is to assess the feasibility of this modified approach to EUS-guided double-balloon-occluded gastroenterostomy bypass (M-EPASS). Methods This was a single-center retrospective study of consecutive patients undergoing M-EPASS from January 2019 to August 2020. The double-balloon device consists of two vascular balloons that optimize the distension of a targeted small-bowel segment for EUS-guided stent insertion. The primary end point was the rate of technical success. Results 11 patients (45% women; mean [standard deviation (SD)] age 64.9 [8.6]) with malignant gastric outlet obstruction were included. Technical and clinical success (ability to tolerate an oral diet) were achieved in 91% (10/11) and 80% (8/10) of patients, respectively. There was one adverse event (9%) due to stent migration. Two patients (18%) required re-intervention for stent obstruction secondary to food impaction. The mean (SD) time to a low residue diet was 3.5 (2.4) days. Conclusion M-EPASS appears to facilitate the technique of EUS-GE, potentially enhancing its safety and clinical adoption. Larger studies are needed to validate this innovative approach to gastric outlet obstruction.

Original languageEnglish (US)
Pages (from-to)170-172
Number of pages3
Issue number2
StatePublished - Feb 2022

ASJC Scopus subject areas

  • Gastroenterology


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