Vivek Kesar MD , William F. Abel MD , Jay Bapaye MD , Reid D. Wasserman DO , Jonathan Rozenberg DO , Subhash Garikipati MD , Klaus E. Mönkemüller MD , Varun Kesar MD , Paul Yeaton MD
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引用次数: 0
Abstract
Background and Aims
Patients with concomitant gastric outlet obstruction (GOO) and biliary obstruction often have limited management options, particularly in the setting of severe debility. We detail the use of EUS-guided gastroduodenal placement of a lumen-apposing metal stent (LAMS) as a conduit for transduodenal ERCP: EUS-directed transduodenal ERCP.
Methods
Nine patients who developed GOO with indwelling biliary metal stents or with anticipated biliary stent placement were retrospectively included.
Results
A 20 mm × 10 mm LAMS was deployed for creation of gastroduodenostomy in all patients. ERCP was performed via the gastroduodenal LAMS with resolution of jaundice in 100% of patients. GOO score improved to 3 in all patients.
Conclusions
This study demonstrates excellent outcomes (resolution of jaundice and GOO) in all chronically ill, poor surgical candidates. Placement of a LAMS allowed for both treatment of GOO and ERCP access for present and future stent exchange.
期刊介绍：
Gastrointestinal Endoscopy is a journal publishing original, peer-reviewed articles on endoscopic procedures for studying, diagnosing, and treating digestive diseases. It covers outcomes research, prospective studies, and controlled trials of new endoscopic instruments and treatment methods. The online features include full-text articles, video and audio clips, and MEDLINE links. The journal serves as an international forum for the latest developments in the specialty, offering challenging reports from authorities worldwide. It also publishes abstracts of significant articles from other clinical publications, accompanied by expert commentaries.
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