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Competing Interests: M. Barthet and J. M. Gonzalez are consultants for Boston Scientific.

Background: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using lumen-apposing metal stents (LAMSs) appears to be effective and safe in gastric outlet obstruction (GOO); however, the EUS-GE procedure is not standardized, with the use of assisted or direct methods still debated. The aim of this study was to compare the outcomes of EUS-GE techniques focusing on an assisted with orointestinal drain wireless endoscopic simplified technique (WEST) and the nonassisted direct technique over a guidewire (DTOG)., Method: This was a multicenter European retrospective study involving four tertiary centers. Consecutive patients who underwent EUS-GE for GOO between August 2017 and May 2022 were included. The primary aim was to compare the technical success and adverse event (AE) rates of the different EUS-GE techniques. Clinical success was also analyzed., Results: 71 patients (mean [SD] age 66.2 10 years; 42.3 % men; 80.3 % malignant etiology) were included. Technical success was higher in the WEST group (95.1 % vs. 73.3 %; estimate of relative risk from odds ratio (eRR) 3.2, 95 %CI 0.94-10.9; P  = 0.01). The rate of AEs was lower in the WEST group (14.6 % vs. 46.7 %; eRR 2.3, 95 %CI 1.2-4.5; P  = 0.007). Clinical success was comparable between the two groups at 1 month (97.5 % vs. 89.3 %). The median follow-up was 5 months (range 1-57)., Conclusion: The WEST resulted in a higher technical success rate with fewer AEs, with clinical success comparable with the DTOG. Therefore, the WEST (with an orointestinal drain) should be preferred when performing EUS-GE., Competing Interests: L. Monino is a consultant for Prion Medical and Braun Medical and has received speaker’s fees from Olympus Belgium and Olympus Europe. E. Pérez-Cuadrado-Robles and J.-M. Gonzalez are consultants for Boston Scientific. P. H. Deprez is a consultant for Boston Scientific and Olympus Europe. T. G. Moreels has received speaker’s fees from Olympus Belgium and Olympus Europe. M. Barthet is a consultant for Boston Scientific.C. Snauwaert, H. Alric, M. Gasmi, S. Ouazzani, H. Benosman, G. Rahmi, and C. Cellier declare that they have no conflict of interest., (Thieme. All rights reserved.)

Competing Interests: Dr. Barthet and Dr. Gonzalez are consultants for Boston Scientific. None of the other authors have any conflict of interest to declare.

Competing Interests: Professor Barthet and Dr. Gonzalez are consultants for Boston Scientific.

Competing Interests: The authors declare that they have no conflict of interest.

Background: Pancreatic neuroendocrine tumors (NETs) and intraductal pancreatic mucinous neoplasia (IPMN) with worrisome features are surgically managed. Endoscopic ultrasound (EUS)-guided radiofrequency ablation (RFA) has recently been developed. The safety of EUS-RFA was the primary end point of this study, its efficacy the secondary end point., Methods: This was a prospective multicenter study that was planned to include 30 patients with a 1-year follow-up with either a NET < 2 cm or a pancreatic cystic neoplasm (PCN), either a branch duct IPMN with worrisome features or a mucinous cystadenoma (MCA). EUS-RFA was performed with an 18G RFA cooling needle., Results: 12 patients had 14 NETs (mean size 13.1 mm, range 10 - 20 mm); 17 patients had cystic tumors (16 IPMNs, 1 MCA; mean size 28 mm, range 9 - 60 mm). Overall three adverse events occurred (10 %), two of these in the first two patients (one pancreatitis, one small-bowel perforation). After these initial patients, modifications in the protocol resulted in a decrease in complications (3.5 %), with one patient having a pancreatic ductal stenosis. Among the 14 NETs, at 1-year follow-up 12 had completely disappeared (86 % tumor resolution), with three patients having a delayed response. Among the 17 PCNs, at 12 months, there were 11 complete disappearances and one diameter that decreased by > 50 % (significant response rate 71 %). All 12 mural nodules showed complete resolution., Conclusions: EUS-RFA of pancreatic NETs or PCNs is safe with a 10 % complication rate, which can be decreased by improved prophylaxis for the procedure., Competing Interests: Marc Barthet received a research grant from Boston Scientific (Endoscopic gastrojejunal anastomosis). Bertrand Napoleon is a consultant for Boston Scientific. All other authors have no financial disclosures or conflicts of interest to declare., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background and Study Aims: The rendezvous endoscopic approach, already described, might be an interesting technique in complete esophageal obstructions (CEO)., Patients and Methods: This retrospective report on nine patients referred because of CEO classified patients into two groups based on length of their esophageal disruption: the long (> 5 cm) group were three patients (esophageal stripping at stent removal [n = 2] and caustic ingestion [n = 1]; two patients having superior esophageal sphincter [SES] destruction); the short (< 5 cm) group were six patients (anastomotic or post-radiotherapy). The procedures were performed under radiographic guidance., Results: All the reconstructions were successful. In four patients, a neo-SES was created, by transillumination (n = 2) or surgery (n = 2). The first dilation was performed by hydrostatic balloon, with additional metal stents (n = 4) and nasogastric tubes (n = 2) used. All the patients were able to eat after the procedure. Two delayed bleeds occurred, which were managed endoscopically. The patients underwent a median of seven dilations (range 3 - 55) over 8 months (2 - 32 months), with dilations ongoing in five patients, but all able to eat normally., Conclusion: Endoscopic rendezvous for CEO is safe and effective, even in patients with long disruptions and complete loss of SES., (© Georg Thieme Verlag KG Stuttgart · New York.)