EUS-DIRECTED TRANS-JEJUNO-GASTRIC BYPASS ERCPS WITH USE OF 20MM LUMEN-APPOSING METAL STENTS (LAMS) IN A PATIENT WITH ROUX-EN-Y GASTRIC BYPASS (RYGB) DUE TO REFRACTORY BILIARY LEAK

2019 ◽  
Author(s):  
R Sanchez-Ocaña ◽  
A Yaiza Carbajo ◽  
J Tejedor ◽  
M De Benito ◽  
J García-Alonso ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Metal Stents ◽  
Biliary Leak

347b: Elevated Stricture Risk Following Covered Self-Expandable Metal Stents (CSEMS) for Biliary Leak After Liver Transplantation?

2010 ◽  
Vol 71 (5) ◽  
pp. AB110
Author(s):  
Melissa S. Phillips ◽  
Jayant P. Talreja ◽  
Indu Srinivasan ◽  
Muhammad A. Javaid ◽  
Michele E. Rehan ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Metal Stents ◽  
Biliary Leak

scholarly journals Use of Lumen-Apposing Metal Stents (LAMS) in the Management of Gastro Jejunostomy Stricture Following Roux En Y Gastric Bypass for Obesity.

2021 ◽  
Author(s):  
Adam Peter Skidmore
Keyword(s):  
Gastric Bypass ◽  
Learning Curve ◽  
Complete Resolution ◽  
High Rate ◽  
Pancreatic Pseudocysts ◽  
Metal Stents ◽  
Efficacy And Safety ◽  
X Ray ◽  
Short Learning Curve ◽  
A Prospective Study

Abstract Background Chronic strictures following Roux en Y Gastric Bypass (RYGB) are a troublesome complication that can lead to significant morbidity. The use of stents has been described but the need for X-ray and risk of migration have meant limited use in the management of these strictures. Lumen apposing metal stents (LAMS) have traditionally been used for management of pancreatic pseudocysts. They don’t require X-ray and are easy to deploy with a short learning curve. This paper explores the use of LAMS to treat post RYGB strictures and explores their safety and efficacy.MethodsA prospective study over a 4-year period looking at 14 patients with post RYGB strictures. These patients have been followed up for between 1 and 3 years. We have prospectively collected data on the efficacy and safety of LAMS in these patientsResults421 patients underwent RYGB in the study period. 14 of these patients developed a stricture that resulted in insertion of LAMS. There was no immediate complications and 12 patients had complete resolution of their stricture. There were no migration related issues.ConclusionLAMS are a safe and effective method to manage post RYGB strictures. They have a high rate of resolution of strictures and can be safely deployed across strictures with no immediate complication. Migration does not appear to be a problem. Insertion is straightforward and doesn’t appear to be associated with a long learning curve.

scholarly journals Endoscopic ultrasound-directed transgastric ERCP in patients with Roux-en-Y gastric bypass using lumen-apposing metal stents or duodenal self-expandable metal stents. A European single-center experience

2020 ◽  
Vol 112 ◽  
Author(s):  
Marina de Benito Sanz ◽  
Ana Yaiza Carbajo López ◽  
Ramón Sánchez-Ocaña Hernández ◽  
Carlos Chavarría Herbozo ◽  
Sergio Bagaza Pérez de Rozas ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Endoscopic Ultrasound ◽  
Metal Stents ◽  
Single Center ◽  
Single Center Experience

scholarly journals Endoscopic treatment of early leaks and strictures after laparoscopic one anastomosis gastric bypass

2020 ◽  
Author(s):  
Fadi Younis ◽  
Mati Shnell ◽  
Nathan Gluck ◽  
Subhi Abu-Abeid ◽  
Shai Eldar ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Endoscopic Treatment ◽  
Staple Line ◽  
One Anastomosis Gastric Bypass ◽  
Metal Stents ◽  
Pneumatic Dilation ◽  
Endoscopic Drainage ◽  
Oral Nutrition ◽  
Anastomotic Strictures ◽  
Staple Line Leaks

Abstract Background: Laparoscopic one anastomosis gastric bypass has become a prominent bariatric procedure. Yet, early and late complications, primarily leaks and strictures, are not uncommon. This study summarizes our experience with endoscopic treatment of laparoscopic one anastomosis gastric bypass complications. Methods: This is a retrospective study of consecutive patients referred to our hospital from 2015 to 2017 with post laparoscopic one anastomosis gastric bypass complications. Therapy was tailored to each case, including fully covered self-expandable metal stents, fibrin glue, septotomy, internal drainage with pigtail stents, through-the-scope and pneumatic dilation. Success was defined as resuming oral nutrition without enteral or parenteral support or further surgical intervention. Results : Nine patients presented with acute or early leaks: 5 (56%) had staple-line leaks, 3 (33%) had anastomotic leaks and 1 (11%) had both. All were treated with stents. Adjunctive endoscopic drainage was applied in 4 patients (44%). Overall 5 patients (56%) with acute/ early leaks recovered completely, including all 3 patients with anastomotic leak and the patient with both leaks but only 1/5 with staple line leak (20%). Complication rate in the leak group reached 22%. Eight patients presented with strictures, 7 at the anastomosis and one due to remnant stomach misalignment. All anastomotic strictures were dilated successfully. However, the patient with the pouch stricture required conversion to Roux-en-Y gastric bypass after 3 failed attempts of dilation. Conclusion: Endoscopic treatments of laparoscopic one anastomosis gastric bypass complications are relatively effective and safe. Anastomosis-related complications are more amenable to endoscopic treatment compared to staple line leaks.

scholarly journals Endoscopic treatment of early leaks and strictures after laparoscopic one anastomosis gastric bypass

2019 ◽  
Author(s):  
Fadi Younis ◽  
Mati Shnell ◽  
Nathan Gluck ◽  
Subhi Abu-Abeid ◽  
Shai Eldar ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Endoscopic Treatment ◽  
Staple Line ◽  
One Anastomosis Gastric Bypass ◽  
Metal Stents ◽  
Pneumatic Dilation ◽  
Endoscopic Drainage ◽  
Oral Nutrition ◽  
Anastomotic Strictures ◽  
Staple Line Leaks

Abstract Background: Laparoscopic one anastomosis gastric bypass has become a prominent bariatric procedure. Yet, early and late complications, primarily leaks and strictures, are not uncommon. This study summarizes our experience with endoscopic treatment of laparoscopic one anastomosis gastric bypass complications. Methods: This is a retrospective study of consecutive patients referred to our hospital from 2015 to 2017 with post laparoscopic one anastomosis gastric bypass complications. Therapy was tailored to each case, including fully covered self-expandable metal stents, fibrin glue, septotomy, internal drainage with pigtail stents, through-the-scope and pneumatic dilation. Success was defined as resuming oral nutrition without enteral or parenteral support or further surgical intervention. Results : Nine patients presented with acute or early leaks: 5 (56%) had staple-line leaks, 3 (33%) had anastomotic leaks and 1 (11%) had both. All were treated with stents. Adjunctive endoscopic drainage was applied in 4 patients (44%). Overall 5 patients (56%) with acute/ early leaks recovered completely, including all 3 patients with anastomotic leak and the patient with both leaks but only 1/5 with staple line leak (20%). Complication rate in the leak group reached 22%. Eight patients presented with strictures, 7 at the anastomosis and one due to remnant stomach misalignment. All anastomotic strictures were dilated successfully. However, the patient with the pouch stricture required conversion to Roux-en-Y gastric bypass after 3 failed attempts of dilatation. Conclusion: Endoscopic treatments of laparoscopic one anastomosis gastric bypass complications are relatively effective and safe. Anastomosis-related complications are more amenable to endoscopic treatment compared to staple line leaks.

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