scholarly journals A Novel Method to Prevent Migration of Gastric Stent

2020 ◽  
Author(s):  
Vikas Singla ◽  
Shivam Khare ◽  
Anil Arora ◽  
Shrihari Anil Anikhindi
Keyword(s):  
Female Patient ◽  
Gastric Outlet Obstruction ◽  
Gastric Wall ◽  
Outlet Obstruction ◽  
Stent Migration ◽  
Metal Stent ◽  
Novel Technique ◽  
Nylon Thread ◽  
Recurrent Vomiting ◽  
Novel Method

AbstractSelf expandable metal stent (SEMS) are widely used in patients with gastric outlet obstruction. Stent migration can occur in these patients, and is an important issue, which needs to be addressed. We used a novel technique for prevention of migration of gastric stent in an 80 year old female. Patient presented with recurrent vomiting due to gastric outlet obstruction by a growth in the antrum. SEMS was placed for palliation of symptoms. A nylon thread multiloop and through the scope clips were used to fix the SEMS with the gastric wall. The technique was used successfully to prevent the migration of SEMS.

Modified endoscopic ultrasound-guided double-balloon-occluded gastroenterostomy bypass (M-EPASS): a pilot study

Endoscopy ◽  
2021 ◽  
Author(s):  
Amanda Marino ◽  
Ali Bessissow ◽  
Corey Miller ◽  
David Valenti ◽  
Louis Boucher ◽  
...  
Keyword(s):  
Gastric Outlet Obstruction ◽  
Endoscopic Ultrasound ◽  
Clinical Success ◽  
Outlet Obstruction ◽  
Stent Migration ◽  
Stent Insertion ◽  
Ultrasound Guided ◽  
Double Balloon ◽  
Low Residue Diet ◽  
The Mean

Abstract Introduction We recently developed a double-balloon device, using widely available existing technology, to facilitate endoscopic ultrasound-guided gastroenterostomy (EUS-GE). Our aim is to assess the feasibility of this modified approach to EUS-guided double-balloon-occluded gastroenterostomy bypass (M-EPASS). Methods This was a single-center retrospective study of consecutive patients undergoing M-EPASS from January 2019 to August 2020. The double-balloon device consists of two vascular balloons that optimize the distension of a targeted small-bowel segment for EUS-guided stent insertion. The primary end point was the rate of technical success. Results 11 patients (45 % women; mean [standard deviation (SD)] age 64.9 [8.6]) with malignant gastric outlet obstruction were included. Technical and clinical success (ability to tolerate an oral diet) were achieved in 91 % (10/11) and 80 % (8/10) of patients, respectively. There was one adverse event (9 %) due to stent migration. Two patients (18 %) required re-intervention for stent obstruction secondary to food impaction. The mean (SD) time to a low residue diet was 3.5 (2.4) days. Conclusion M-EPASS appears to facilitate the technique of EUS-GE, potentially enhancing its safety and clinical adoption. Larger studies are needed to validate this innovative approach to gastric outlet obstruction.

scholarly journals Endoscopic Diagnosis of Bouveret Syndrome

2020 ◽  
Vol 14 (3) ◽  
pp. 683-686
Author(s):  
Felix Hesse ◽  
Mohamed Abdelhafez ◽  
Christoph Schlag ◽  
Roland M. Schmid ◽  
Tobias Lahmer
Keyword(s):  
Computed Tomography ◽  
Female Patient ◽  
Gastric Outlet Obstruction ◽  
Rare Complication ◽  
Gallstone Ileus ◽  
Duodenal Bulb ◽  
Outlet Obstruction ◽  
Endoscopic Diagnosis ◽  
Endoscopic Imaging ◽  
Bouveret Syndrome

Bouveret syndrome is a form of gallstone ileus and a rare complication of chole(cysto)lithiasis. It describes gastric outlet obstruction secondary to an impacted gallstone. Here, we report a case of an 82-year-old female patient with gastric outlet obstruction and penetration of gallstones into the duodenal bulb on endoscopic imaging. Based on these findings Bouveret syndrome was diagnosed and confirmed by computed tomography.

scholarly journals Su1449 EUS-GUIDED GASTROJEJUNOSTOMY USING A LUMEN APPOSING METAL STENT IN PATIENTS WITH SYMPTOMATIC GASTRIC OUTLET OBSTRUCTION

2018 ◽  
Vol 87 (6) ◽  
pp. AB359
Author(s):  
Adeel Urrehman ◽  
Christopher J. Khor ◽  
Chin Yung Ka ◽  
Ravishankar Asokkumar ◽  
Damien Tan
Keyword(s):  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Metal Stent

scholarly journals A pilot study of novel duodenal covered self-expandable metal stent fixation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yasuki Hori ◽  
Kazuki Hayashi ◽  
Itaru Naitoh ◽  
Katsuyuki Miyabe ◽  
Makoto Natsume ◽  
...  
Keyword(s):  
Pilot Study ◽  
Adverse Events ◽  
Gastric Outlet Obstruction ◽  
Clinical Success ◽  
Performance Status ◽  
Outlet Obstruction ◽  
Poor Performance ◽  
Stent Migration ◽  
Poor Performance Status ◽  
Sems Placement

AbstractMigration of duodenal covered self-expandable metal stents (C-SEMSs) is the main cause of stent dysfunction in patients with malignant gastric outlet obstruction (mGOO). Because endoscopic SEMS placement is frequently selected in patients with poor performance status, we concurrently focused on the safety of the treatment. This pilot study included 15 consecutive patients with mGOO who underwent duodenal partially covered SEMS (PC-SEMS) placement with fixation using an over-the-scope-clip (OTSC). Technical feasibility, clinical success for oral intake estimated by the Gastric Outlet Obstruction Scoring System (GOOSS) score, and adverse events including stent migration were retrospectively assessed. All procedures were successful, and clinical success was achieved in 86.7% (13/15). Mean GOOSS scores were improved from 0.07 to 2.53 after the procedure (P < 0.001). Median survival time was 84 days, and all patients were followed up until death. Stent migration occurred in one case (6.7%) at day 17, which was successfully treated by removal of the migrated PC-SEMS using an enteroscope. For fixation using an OTSC, additional time required for the procedure was 8.9 ± 4.1 min and we did not observe OTSC-associated adverse events. Poor performance status was associated with clinical success (P = 0.03), but we could provide the treatment safely and reduce mGOO symptoms even in patients with poor performance status. In conclusion, duodenal PC-SEMS fixation using an OTSC is feasible for preventing stent migration in patients with mGOO including those with poor performance status.

Feasibility of Duodenal Covered Self-Expandable Metal Stent Fixation: A Pilot Study (With Video)

2021 ◽  
Author(s):  
Yasuki Hori ◽  
Kazuki Hayashi ◽  
Itaru Naitoh ◽  
Katsuyuki Miyabe ◽  
Makoto Natsume ◽  
...  
Keyword(s):  
Pilot Study ◽  
Adverse Events ◽  
Gastric Outlet Obstruction ◽  
Clinical Success ◽  
Performance Status ◽  
Outlet Obstruction ◽  
Poor Performance ◽  
Stent Migration ◽  
Poor Performance Status ◽  
Sems Placement

Abstract Migration of duodenal covered self-expandable metal stents (C-SEMSs) is the main cause of stent dysfunction in patients with malignant gastric outlet obstruction (mGOO). Because endoscopic SEMS placement is frequently selected in patients with poor performance status, we concurrently focused on the safety of the treatment. This pilot study included 15 consecutive patients with mGOO who underwent duodenal C-SEMS placement with fixation using an over-the-scope-clip (OTSC). Technical feasibility, clinical success for oral intake estimated by the Gastric Outlet Obstruction Scoring System (GOOSS) score, and adverse events including stent migration were assessed. All procedures were successful, and clinical success was achieved in 86.7% (13/15). Mean GOOSS scores were improved from 0.07 to 2.53 after the procedure (P < 0.001). Stent migration occurred in one case (6.7%) with no other adverse events. For fixation using an OTSC, additional time required for the procedure was 8.9 ± 4.1 minutes. Poor performance status was associated with clinical success (P = 0.03), but we could provide the treatment safely and reduce mGOO symptoms even in patients with poor performance status. In conclusion, duodenal C-SEMS fixation using an OTSC is feasible for preventing stent migration in patients with mGOO including those with poor performance status.

scholarly journals False Gastric Diverticulum Arising from the Pylorus Associated with Gastric Outlet Obstruction

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Umesh Jayarajah ◽  
Oshan Basnayake ◽  
Pradeep Wijerathne ◽  
Jayan Jayasinghe ◽  
Nilesh Fernandopulle ◽  
...  
Keyword(s):  
Gastric Outlet Obstruction ◽  
Gastric Wall ◽  
Outlet Obstruction ◽  
Unusual Site ◽  
Gastric Diverticulum ◽  
Multiple Biopsies ◽  
Undigested Food ◽  
Posterior Gastric Wall ◽  
Gastric Malignancy ◽  
Vague Abdominal Pain

A gastric diverticulum is an outpouching from the stomach wall. It is usually seen in the posterior gastric wall and the gastric antrum. Diverticula arising from the pyloric region are extremely rare. A 59-year-old female presented with progressively worsening symptoms of gastric outlet obstruction associated with dyspepsia and vague abdominal pain for 5 years. A large, thin-walled, wide-mouthed, false gastric diverticulum (filled with undigested food) arising from the pylorus associated with gastric outlet stenosis was found by endoscopy and CT imaging. Multiple biopsies from the region excluded a gastric malignancy. A gastrojejunostomy and jejunojejunostomy were performed to bypass the obstruction which successfully relieved the symptoms. This is an unusual site for gastric diverticula, and when associated with gastric outlet obstruction, further distention of the diverticulum may cause more obstruction with worsening symptoms.

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