Long-term outcomes of EUS-guided balloon-occluded gastrojejunostomy bypass for malignant gastric outlet obstruction (with video)

Post written by Takayoshi Tsuchiya, MD, PhD, FJGES, from the Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan. This study focuses on the long-term outcomes of the EUS-guided balloon-occluded gastrojejunostomy bypass (EPASS) technique for malignant gastric outlet obstruction (GOO). EPASS is a novel procedure developed by our team at Tokyo Medical University that combines a …

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EUS-guided gastrojejunostomy using a pre-existing PEG with jejunal extension for target bowel opacification

Post written by Laurens Janssens, MD, from the Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA. A 71-year-old woman presented with abdominal pain, nausea, vomiting, and normal liver test results. A CT scan demonstrated gastric outlet obstruction (GOO). Extensive work-up could not reveal the etiology of an extrinsic duodenal compression, and we were unable …

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EUS-guided Braun-type enteroenterostomy for management of an afferent limb–type obstruction in a patient with prior surgical gastrojejunostomy

Post written by Kamal M. Hassan, MD, from Weill Cornell Medicine, New York, New York, USA. In this case, a 78-year-old patient with a history of numerous abdominal surgeries complicated by adhesions and small-bowel obstructions underwent an eventual surgical gastrojejunostomy. The patient developed progressive peroral intolerance, and imaging revealed an acquired afferent loop syndrome as a …

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Dilation balloon-occlusion technique for EUS-guided gastrojejunostomy

Post written by Samuel Han, MD, from The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. In this video with 2 cases, we describe a technique for performing an EUS-guided gastrojejunostomy using commonly available endoscopic devices, including an 18- to 20-mm dilation balloon (CRE Balloon Dilatation Catheter; Boston Scientific, Marlborough, Mass, USA). Upon identifying the site …

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Endoscopic management of gastrojejunocolic fistula after endoscopic gastrojejunostomy

Post written by Tamasha Persaud, MD, from New York Presbyterian/Weill Cornell Medical Center, New York, New York, USA. In this video case report, we describe the formation of a gastrojejunocolic fistula (GCF) as a rare delayed sequela of EUS-guided gastrojejunostomy (EUS-GJ) and demonstrate how tandem stent placement with a long covered metal stent can be an …

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EUS-guided gastrojejunostomy for relief of gastric outlet obstruction from a large duodenal hematoma

Post written by Theodore W. James, MD, from the Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. We present the first reported use of an EUS-guided gastrojejunostomy for the treatment of gastric outlet obstruction from a large duodenal hematoma. A 44-year-old man with a history of alcoholic pancreatitis presented …

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One-step EUS-guided gastrojejunostomy

Nobuhito Ikeuchi, MD, Department of Gastroenterology and Hepatology at Tokyo Medical University in Tokyo, Japan presents this video case “One-step EUS-guided gastrojejunostomy with use of lumen-apposing metal stent for afferent loop syndrome treatment.” Afferent loop syndrome is an adverse event of several types of gastric surgery and often causes patient suffering. However, retrograde endoscopic decompression …

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Novel EUS-guided gastrojejunostomy technique

Takao Itoi, MD, PhD, FASGE from the Tokyo Medical University in Tokyo, Japan discusses his article "Novel EUS-guided gastrojejunostomy technique using a new double-balloon enteric tube and lumen-apposing metal stent (with videos)" from the New Methods section of the December issue. Advanced gastric, duodenal, and peri-pancreatic cancers can show gastric outlet obstruction (GOO) at the …

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