EUS-guided duodenojejunostomy by use of a 2-cm LAMS to treat proximal jejunal stricture in a patient with chronic pancreatitis

Post written by Michael Lajin, MD, from the Sharp Grossmont Hospital, La Mesa, California, USA. A 26-year-old man presented with a 2-week history of nausea and vomiting. His medical history was significant for recurrent pancreatitis secondary to hypertriglyceridemia, infected walled-off necrosis requiring cystogastrostomy, splenic vein thrombosis resulting in severe portal hypertensive gastropathy, and large gastric …

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Intraperitoneal echoendoscopy for rescue of a gastrojejunal anastomosis

Post written by Theodore W. James, MD, from the Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. We describe our experience rescuing a maldeployed lumen-apposing metal stent (LAMS) by passing an endoscopic ultrasound scope through the proximal end of the stent and re-puncturing the target bowel from within the …

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EUS-guided enterocolostomy for palliation of malignant distal small-bowel obstruction

Post written by Shelini Sooklal, MD, and Anand Kumar, MD, MPH, from the Division of Gastroenterology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA. Our video case describes the implementation of a therapeutic endoscopic ultrasound (EUS) technique to provide palliative relief of recurrent small bowel obstruction in a patient with metastatic adenocarcinoma of the colon …

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Efficacy of a novel lumen-apposing metal stent for the treatment of symptomatic pancreatic pseudocysts

Post written by Tae Jun Song, MD, PhD, Sang Soo Lee, MD, PhD, Jong Ho Moon, MD, PhD, from the Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, and the Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon, Republic of Korea. We investigated the effectiveness and safety …

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Management of afferent limb obstruction by EUS-guided jejunojejunostomy and placement of LAMS

Post written by Hassan Ghoz, MD, and Victoria Gómez, MD, from the Division of Gastroenterology and Hepatology, Section of Advanced Endoscopy, Mayo Clinic, Jacksonville, Florida, USA. We describe a case of a patient presenting with malignant afferent loop obstruction (ALO) which we managed using EUS-guided creation of a jejunojejunostomy with a lumen-apposing metal stent (LAMS). …

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Endoscopic replacement technique for migrated LAMS during endoscopic pancreatic necrosectomy

Post written by Mitsuru Okuno, MD, PhD, from the Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan. EUS-guided drainage of walled-off necrosis (WON) is the accepted efficient and safe standard of care. The LAMS has a large lumen (up to 10 mm) and dual flanges that tightly adhere the LAMS to the fistula within the …

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Rescue of a delayed spontaneously migrated lumen-apposing metal stent placed to facilitate transluminal ERCP

Post written by Prabhleen Chahal, MD, FACG, FASGE, and C. Roberto Simons-Linares, MD, MSc, from the Gastroenterology and Hepatology Department, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. We present a case of a delayed spontaneously migrated lumen-apposing metal stent (LAMS) that was placed in a patient with a history of Roux-en-Y gastric bypass …

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EUS-guided cystesophagostomy using a LAMS for drainage of a pancreatic fluid collection in a pediatric patient

Post written by Ryan Law, DO, from the Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA. An 8-year-old boy was referred for abdominal pain of unclear etiology, dysphagia, and failure to thrive. He had multiple visits to the emergency room over a 5-year period for abdominal pain of unclear etiology. After routine evaluation …

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Retrieval and redeployment of migrated LAMS to facilitate endoscopic necrosectomy of walled-off necrosis

Post written by Shashideep Singhal, MD, FASGE, from the Gastrointestinal Care Consultants, Houston, Texas, USA.                  Walled-off necrosis (WON) develops as a sequel to acute pancreatitis. Approximately 15% of patients with acute pancreatitis can experience WON. EUS-guided transmural drainage of WON has been a safe, efficacious, and widely used therapeutic modality in recent times. The …

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Safety and efficacy of lumen-apposing metal stents with and without simultaneous double-pigtail plastic stents

Post written by Kulwinder S. Dua, MD, FASGE, FACP, FRCP, from the Department of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, USA. Lumen-apposing metal stents (LAMSs) have a large internal diameter and hence are routinely used to manage walled-off pancreatic necrosis. Secondary to their simplicity in deployment as a single-step procedure, LAMSs are also …

Continue reading Safety and efficacy of lumen-apposing metal stents with and without simultaneous double-pigtail plastic stents