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Endoscopy 2021; 53(03): 293-297
DOI: 10.1055/a-1223-2302
Innovations and brief communications

Long-term placement of lumen-apposing metal stent after endoscopic ultrasound-guided duodeno- and jejunojejunal anastomosis for direct access to excluded jejunal limb

Gianfranco Donatelli
1   Unité d’Endoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
,
Fabrizio Cereatti
1   Unité d’Endoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
2   Gastroenterologia ed Endoscopia Digestiva ASST Cremona, Cremona, Italy
,
Andrea Spota
1   Unité d’Endoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
3   Università degli studi di Milano, Scuola di Specializzazione in Chirurgia Generale, Milano, Italy
,
David Danan
1   Unité d’Endoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
,
Thierry Tuszynski
1   Unité d’Endoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
,
Jean-Loup Dumont
1   Unité d’Endoscopie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
,
Serge Derhy
4   Unité de Radiologie Interventionnelle, Hôpital Privé des Peupliers, Ramsay Santé, Paris, France
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Long-standing enteroenteric anastomosis with lumen-apposing metal stents to access bilioenteric anastomotic strictures: yes we can!Endoscopy 2021; 53(03): 298-299
DOI: 10.1055/a-1258-4306

Abstract

Background Management of biliary disorders in patients with altered anatomy may be challenging. Endoscopic ultrasound (EUS)-guided gastrointestinal anastomosis using a lumen-apposing metal stent (LAMS) was introduced to allow endoscopic retrograde cholangiography (ERC) in such cases. However, the appropriate stent indwelling time remains uncertain. We report long-term LAMS deployment after duodenojejunal or jejunojejunal anastomosis (EUS-DJA) to allow endoscopic reinterventions in cases of recurrences.

Methods 11 consecutive patients underwent EUS-DJA with long-standing LAMS between January 2017 and December 2018. Over a 12-month period, ERC treatment was carried out with multiple endoscopic sessions across the DJA.

Results Technical success was 91 % (10/11) for EUS-DJA and 100 % for ERC. Four patients presented stricture recurrence at a mean of 489 days (standard deviation [SD] 31.7) after the end of ERC treatment. A novel ERC across the LAMS anastomosis was feasible in all cases. At a mean of 781 days (SD 253.1), all LAMS remained in place with no evidence of complications.

Conclusion Long-term LAMS placement after EUS-DJA may be feasible and safe for direct access to the excluded limb.

Supplementary material



Publication History

Received: 27 April 2020

Accepted: 22 June 2020

Article published online:
06 August 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
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