Hugo Uchima, MD, from the Gastrointestinal Endoscopy Department, Centro Médico Teknon, in Barcelona, Spain shares this video case, “Lumen-apposing metal stent for the treatment of refractory gastrojejunal anastomotic stricture after laparoscopic gastric bypass.”
In this video case we show how a short fibrotic stricture can be treated successfully with a lumen-apposing metal stent.
Our patient is a young female who developed oral intolerance due to a gastrojejunal anastomotic stricture, one year after laparoscopic gastric bypass. After 2 attempts of endoscopic balloon dilation (including a perforation during the second dilation that was medically managed), the stricture was the same size and she persisted symptomatic, so finally we decided to use a lumen-apposing metal stent (Axios, Xlumena, Mountain View, California) because its shape fits neatly into a short stricture (like anastomotic ones), and has the adequate lumen diameter for gastric bypass anastomosis, in which a maximum diameter of 12 to 15 mm is desired.
This case shows that the use of this kind of lumen-apposing metal stents might be a good and safe alternative in the treatment of gastrojejunal anastomotic stricture.
This lumen-apposing metal stents may be a good alternative for short fibrotic strictures like anastomotic strictures, not only in gastrojejunal anastomotis, but also in esophageal and colonic anastomotic stricture (but using larger diameter devices).
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