Mitigating lumen-apposing metal stent dislodgment and allowing safe, single-stage EUS-directed transgastric ERCP Shayan Irani, MD, Julian Yang, MD, Mouen.

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Presentation transcript:

Mitigating lumen-apposing metal stent dislodgment and allowing safe, single-stage EUS-directed transgastric ERCP Shayan Irani, MD, Julian Yang, MD, Mouen A. Khashab, MD VideoGIE Volume 3, Issue 10, Pages 322-324 (October 2018) DOI: 10.1016/j.vgie.2018.07.008 Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 CT scan demonstrating pancreatitis and a distal common bile duct stone in Patient 1. VideoGIE 2018 3, 322-324DOI: (10.1016/j.vgie.2018.07.008) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Use of 15-mm cautery-enhanced lumen-apposing metal stent to create a gastrogastric fistula in Patient 1. VideoGIE 2018 3, 322-324DOI: (10.1016/j.vgie.2018.07.008) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 Lumen-apposing metal stent secured to the gastric pouch with an 11/6t over-the-scope clip in Patient 1. VideoGIE 2018 3, 322-324DOI: (10.1016/j.vgie.2018.07.008) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 Use of argon plasma coagulation to cut and remove the over-the-scope clip securing the lumen-apposing metal stent in Patient 1. VideoGIE 2018 3, 322-324DOI: (10.1016/j.vgie.2018.07.008) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 5 Upper-GI series confirming closure of gastrogastric fistula 4 weeks after removal of lumen-apposing metal stent in Patient 1. VideoGIE 2018 3, 322-324DOI: (10.1016/j.vgie.2018.07.008) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 6 Lumen-apposing metal stent secured with 2 sutures to the gastric pouch in Patient 2. VideoGIE 2018 3, 322-324DOI: (10.1016/j.vgie.2018.07.008) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions