Post written by Armin Küllmer, MD, from the Department of Medicine I, Klinikum Ludwigsburg, Ludwigsburg, Germany.

We proudly present our video of an endoscopic jejunojejunostomy in order to bypass an obstructed efferent loop after subtotal gastrectomy with Roux-en-Y reconstruction. The endoscopic anastomosis was made using a lumen-apposing stent.

The patient suffered from daily vomiting and postprandial pain after the surgical operation. Since he had a recurrence of gastric cancer, a surgical re-intervention was not a favorable option in this palliative cancer setting. A percutaneous endoscopic jejunostomy could have been performed easily, but since the anatomical problem would not have been resolved, the patient would not have been able to take food by mouth. In order to improve the quality of life of our patient, we performed endoscopic interenteric anastomosis using the a lumen-apposing self-expandable metal stent. Afterward, not only did his symptoms go away, but he was also able to take in food orally.

Interenteric anastomosis can be made safe and effective by using lumen-apposing metal stents. They are an alternative to surgical interventions in selected patients.

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