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 …

Continue reading Endoscopic replacement technique for migrated LAMS during endoscopic pancreatic necrosectomy

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 …

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

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 …

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

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 …

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

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

Management of an esophagojejunal anastomotic stricture using a LAMS

Post written by Ryan Law, DO, from the Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA. We present a 56-year-old woman with history of lupus and laparoscopic Roux-en-Y gastric bypass (RYGB), complicated by a persistent anastomotic ulcer ultimately requiring partial gastrectomy and esophagojejunostomy who was referred for endoscopic management of an esophagojejunal (EJ) …

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Massive bleeding after EUS-guided walled-off necrosis drainage

Post written by Lady Katherine Mejia Perez, MD, and Victoria Gómez, MD, from the Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA. We describe a case of a 58-year-old man with necrotizing pancreatitis of biliary origin who underwent endoscopic drainage of a large, 12-cm pancreatic collection consistent with walled-off necrosis. A 15-mm diameter …

Continue reading Massive bleeding after EUS-guided walled-off necrosis drainage