Definitive nonsurgical management of stump cholecystitis with EUS-guided lumen-apposing metal stent placement and electrohydraulic lithotripsy

Post written by Rishi Pawa, MD, from the Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. A 31-year-old woman presented with right-upper-quadrant pain and imaging findings of acute cholecystitis. She underwent an open subtotal cholecystectomy because of extensive adhesive disease involving the gallbladder.  Initially, the patient did well postoperatively but started having recurrent symptoms …

Continue reading Definitive nonsurgical management of stump cholecystitis with EUS-guided lumen-apposing metal stent placement and electrohydraulic lithotripsy

Helix tack for lumen-apposing metal stent fixation in single-session EUS-directed transgastric ERCP

Post written by Kambiz S. Kadkhodayan, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA. We describe the use of a helix tack system to anchor the proximal flange of a lumen-apposing metal stent (LAMS) to the gastric pouch during a single-session EUS-directed transgastric ERCP (SS-EDGE). This video case also describes a reverse …

Continue reading Helix tack for lumen-apposing metal stent fixation in single-session EUS-directed transgastric ERCP

Endoscopic ultrasound-guided ileosigmoidostomy using a lumen-apposing metal stent for palliation of malignant small-bowel obstruction

Post written by Donevan Westerveld, MD, from the Division of Gastroenterology & Hepatology, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA. A high-grade malignant small-bowel obstruction (SBO) is typically managed with surgical diversion (ileostomy) or palliative decompression via nasogastric tube or venting gastrostomy. These approaches have a significant impact on a patient’s quality of …

Continue reading Endoscopic ultrasound-guided ileosigmoidostomy using a lumen-apposing metal stent for palliation of malignant small-bowel obstruction

Cystgastrostomy with EUS-directed jejunogastric LAMS

Amy Tyberg, MD, from the Division of Gastroenterology and Hepatology, Weil Cornell Medical College, Cornell University, in New York, New York, USA shares this video case "EUS-directed jejunogastric lumen-apposing metal stent to facilitate cystgastrostomy in a patient with Roux-en-Y anatomy." This case describes a 54-year-old man with Roux-en-Y anatomy who presented with a symptomatic pancreatic …

Continue reading Cystgastrostomy with EUS-directed jejunogastric LAMS

Treating a refractory gastrojejunal anastomotic stricture

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 …

Continue reading Treating a refractory gastrojejunal anastomotic stricture