EUS-directed transduodenal ERCP in concomitant gastric outlet and biliary obstruction - 04/04/25
, Jay Bapaye, MD 1, Reid D. Wasserman, DO 2, Jonathan Rozenberg, DO 2, Subhash Garikipati, MD 1, Klaus E. Mönkemüller, MD 1, Varun Kesar, MD 1, Paul Yeaton, MD 1Abstract |
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.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Abbreviations : EDDE, EUS-GD, EUS-GE, GOO, LAMS
Plan
Vol 101 - N° 4
P. 885-889 - avril 2025 Retour au numéro
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